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Sarah C Brüningk1, Florian Kamp1, Jan J Wilkens1

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A new Equivalent Uniform Effect (EUE) model simplifies carbon ion therapy planning by accounting for organ response. This approach offers comparable treatment plan quality to existing methods while improving biological outcome optimization.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Computational Biology

Background:

  • Carbon ion therapy planning requires accurate biological response modeling.
  • Existing Equivalent Uniform Dose (EUD) models are not directly applicable to carbon ion therapy.
  • Relative Biological Effectiveness (RBE) models cellular response but not whole-organ impact.

Purpose of the Study:

  • Introduce the Equivalent Uniform Effect (EUE) concept for carbon ion and photon therapies.
  • Develop a new model for biological treatment plan optimization in carbon ion therapy.
  • Address limitations of current EUD models in carbon ion therapy.

Main Methods:

  • Defined EUE as the biologically equivalent uniform effect yielding the same injury probability as inhomogeneous effects.
  • Formulated EUE using a generalized mean effect and an effect-volume parameter.
  • Implemented EUE and EUD concepts with quadratic and logistic objective functions in a treatment planning system.
  • Calculated exemplary treatment plans for a head-and-neck patient.

Main Results:

  • EUE-based optimization yielded treatment plans comparable to RBE-weighted EUD approaches.
  • Biological objective function optimization resulted in superior final EUD for organs at risk (OARs).
  • Quadratic objective functions showed absolute OAR sparing gains; logistic approaches showed intersecting DVHs.
  • Treatment plans maintained similar quality even with parameter under- or overestimations.

Conclusions:

  • EUE-based optimization is a viable tool for carbon ion therapy treatment planning.
  • EUE allows for more specific biological outcome optimization while accounting for voxel-to-voxel variations.
  • This approach may reduce computational costs and facilitate comparisons between fractionation schemes and modalities.