Clinical Applications of RBE in Carbon Ion Radiation Therapy: Current Status and Consensus Statements

Area of Science:

• Medical Physics
• Radiation Oncology
• Biophysics

Background:

• Carbon ion therapy leverages high relative biological effectiveness (RBE) for improved radiation treatment.
• Accurate RBE computation is essential for clinical application, relying on biophysical models.
• Current clinical RBE models produce divergent predictions, hindering dose comparability.

Purpose of the Study:

• To highlight discrepancies in RBE model predictions for carbon ion therapy.
• To analyze the impact of different RBE models on absorbed and RBE-weighted doses.
• To explore approaches for translating doses between different RBE modeling systems.

Main Methods:

• Review and comparison of existing biophysical models for RBE calculation.
• Analysis of dose prescription systems and their underlying RBE conventions.
• Development of expert consensus statements on RBE modeling and dose translation.

Main Results:

• Significant variations in RBE-weighted dose predictions exist across different models.
• Discrepancies in model application and conventions further complicate dose comparisons.
• Expert consensus identifies key challenges in RBE model harmonization.

Conclusions:

• Harmonizing RBE models and dose concepts is critical for comparable carbon ion therapy outcomes.
• Dose translation between planning systems is feasible, enabling multi-institutional collaboration.
• Addressing RBE modeling complexities facilitates novel treatment planning and joint clinical studies.