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Biological Effects of Radiation

Biological Effects of Radiation

All radioactive nuclides emit high-energy particles or electromagnetic waves. When this radiation encounters living cells, it can cause heating, break chemical bonds, or ionize molecules. The most serious biological damage results when these radioactive emissions fragment or ionize molecules. For example, α and β particles emitted from nuclear decay reactions possess much higher energies than ordinary chemical bond energies. When these particles strike and penetrate matter, they...

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Cumulative Dose Analysis in Adaptive Carbon Ion Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer.

Zhuojun Ju¹, Makoto Sakai², Xiangdi Meng¹

¹Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi 3718511, Japan.

|August 28, 2025

Summary

Adaptive radiotherapy (ART) in carbon ion radiotherapy (CIRT) improved target dose coverage for locally advanced non-small cell lung cancer (LA-NSCLC) without increasing normal tissue toxicity. This supports integrating weekly monitoring for precise dose delivery.

Keywords:

adaptive radiotherapy carbon ion radiotherapy cumulative dose distribution locally advanced non-small cell lung cancer weekly computed tomography

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Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

Published on: March 11, 2021

Area of Science:

Oncology
Radiation Oncology
Medical Physics

Background:

Locally advanced non-small cell lung cancer (LA-NSCLC) requires precise radiation delivery.
Adaptive radiotherapy (ART) aims to adjust treatment based on anatomical changes during therapy.
Carbon ion radiotherapy (CIRT) offers potential advantages in dose distribution and biological effectiveness.

Purpose of the Study:

To evaluate the precision of dose delivery in adaptive CIRT for LA-NSCLC using cumulative dosimetry.
To compare dosimetry parameters between as-scheduled and adaptive plans.
To assess survival outcomes and toxicity in patients receiving ART versus non-ART.

Main Methods:

Forty-six LA-NSCLC patients receiving CIRT (64 Gy[RBE] in 16 fractions) were analyzed.
Weekly CT scans were used for offline ART if dose distribution significantly worsened.
Deformable image registration integrated daily doses into plan CT scans for dosimetry comparison.

Main Results:

ART improved median V98% (96.5% to 98.1%) and D98% (60.5 to 62.7 Gy[RBE]) for clinical tumor volume (p < 0.001).
Dose distribution conformity and uniformity improved with ART (p < 0.001).
No significant differences in normal tissue doses or survival outcomes were observed between ART and non-ART groups.

Conclusions:

ART enhances target dose coverage in CIRT for LA-NSCLC while maintaining normal tissue safety.
Weekly CT monitoring and ART integration are beneficial for precise dose delivery amidst anatomical variations.
ART is a valuable strategy for optimizing CIRT in LA-NSCLC treatment.