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Equivalent-Uniform-Dose Optimization for Spatially Fractionated Radiation Therapy.

Ya-Nan Zhu1, Weijie Zhang2, Yuting Lin3

  • 1School of Mathematics, Harbin Institute of Technology, Harbin, China.

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|October 24, 2025
PubMed
Summary
This summary is machine-generated.

Spatially fractionated radiotherapy (SFRT) planning using equivalent uniform dose (EUD) optimization improves tumor control and organ sparing. This novel method reduces EUD and increases survival fractions for patients undergoing SFRT.

Keywords:
equivalent uniform doseinverse optimizationspatially fractionated radiotherapy (SFRT)treatment planning

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Computational Biology

Background:

  • Spatially fractionated radiotherapy (SFRT) utilizes peak-valley dose patterns to enhance tumor control and organ sparing compared to conventional radiotherapy (CONV).
  • Conventional physical dose metrics inadequately capture the biological effectiveness of SFRT's non-uniform dose distributions.
  • Equivalent Uniform Dose (EUD) serves as a surrogate metric for evaluating biological effectiveness in non-uniform dose scenarios.

Purpose of the Study:

  • To develop and present a novel treatment planning method for SFRT incorporating Equivalent Uniform Dose (EUD) optimization.
  • This represents the first known approach to integrate EUD optimization into SFRT planning.

Main Methods:

  • Proton GRID therapy with uniform target dose was modeled for dose-only optimization (DO) and joint dose and peak-valley-dose-ratio (PVDR) optimization (JDPO).
  • SFRT treatment planning was enhanced to include EUD optimization, based on the linear-quadratic cell survival model.
  • Optimization employed iterative convex relaxation for dose-volume-histogram constraints and a linearized alternating direction method of multipliers for monitor-unit and EUD objectives.

Main Results:

  • EUD optimization successfully reduced EUD values and increased survival fractions across different planning scenarios.
  • For a head-and-neck patient, brainstem EUD decreased significantly with EUD optimization (e.g., from 5.52% to 3.86% for DO).
  • Brainstem survival fraction increased substantially with EUD optimization (e.g., from 72.9% to 81.6% for DO), while preserving PVDR.

Conclusions:

  • A novel method for EUD optimization in SFRT planning has been successfully developed.
  • This approach effectively reduces EUD and enhances survival fractions, offering improved therapeutic outcomes.
  • The proposed method integrates biological effectiveness into treatment planning, optimizing SFRT delivery.