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SU-E-T-461: Fractionation Schedule Optimization for Lung Cancer Treatments Using Radiobiological and Dose

H Keller1,2, G Meier1,2, A Hope1,2

  • 1Princess Margaret Hospital, Toronto, Ontario, Canada.

Medical Physics
|May 19, 2017
PubMed
Summary
This summary is machine-generated.

A new mathematical criterion, the bifurcation number, can help select optimal lung cancer radiotherapy fractionation. This method aids in choosing between hypofractionation or standard/hyperfractionation based on normal tissue dose distributions.

Keywords:
BifurcationsCancerDosimetryLungsNumerical solutionsOptimizationRadiation therapyStatistical propertiesTherapeuticsTissues

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Area of Science:

  • Radiation oncology
  • Medical physics
  • Biophysics

Background:

  • Radiotherapy for lung cancer utilizes diverse fractionation protocols.
  • Protocol selection often depends on target volume size and normal tissue dose constraints.
  • Optimizing tumor effect while managing normal tissue complications is crucial.

Purpose of the Study:

  • To derive mathematical criteria for normal tissue (NT) dose distributions.
  • To determine fractionation schedules maximizing the linear-quadratic tumor effect.
  • To identify a method for selecting optimal dose per fraction schedules.

Main Methods:

  • An optimization problem was formulated to maximize tumor effect and constrain NT complication probability using the Lyman-Kutcher-Burman model.
  • A scale-free "bifurcation" number derived from the NT dose-volume histogram (DVH) was introduced.
  • The clinical relevance of the bifurcation number was evaluated in 30 non-small-cell lung cancer patients.

Main Results:

  • The bifurcation number effectively classified hypofractionated versus conventional fractionation groups for lung and esophagus.
  • Intra-patient variability of bifurcation numbers was lower than that of treated volumes in the conventional fractionation group.
  • Prescribed fractionations aligned with accepted alpha-beta values for tumor and radiation pneumonitis.

Conclusions:

  • Model-based criteria, like the bifurcation number, can potentially replace empirical volume criteria for selecting optimal fractionation protocols.
  • This approach aids in optimizing dose distribution and fractionation post-treatment planning.