Relative biologic effectiveness in terms of tumor response of 125I implants compared with 60Co gamma rays

To measure the relative biologic effectiveness (RBE) for 125I seeds compared with external beam radiotherapy using a clinically relevant in vivo system.

Photon emission from a detailed source model was simulated using the Monte Carlo code MCNP4C, sampling from a 125I spectrum. The mouse RIF-1 tumor was treated with either temporary implant of an 125I seed or with 60Co gamma rays. The tumors were always the same size at the initiation of treatment, and the endpoint was growth inhibition.

The dose-response curve for both modalities was close to linear and was independent of the initial 125I activity (dose rate) for the range investigated. Calculation of the RBE for tumor response requires assigning a unique value for the tumor dose that is not homogenous but depends on the distance from the 125I source. Because tumor regrowth will depend on the subpopulation of cells that have the greatest probability of survival (i.e., those at the greatest distance from the 125I source), one approach is to use the dose to this population. On this basis, the RBE for 125I compared with 60Co gamma rays is 1.5. If the 125I dose is computed as the average dose to the tumor, corrected for the dose that is wasted as overkill in the cell population closest to the center of the 125I seed, the RBE is 1.4.

The result, an RBE of 1.4-1.5 is similar to findings obtained by other methods, supporting the validity of this approach to derive an RBE with validity in a clinical context.