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Volume 2, Number 1, 1997

How effectively to use biophysical models in treatment planning?

Pavel Matula

Summary:

In any radiotherapy treatment, changes in either the dose-rate or pattern of fractionation will induce changes in the radiobiological response of normal tissues and tumours. In mixed modality regimen an assessment of the overall biological effect cannot be determined simply by summing the physical doses instead it is necessary to make use of the concept of Biologically Effective Dose (BED) (Barendsen, 1982, Fowler, 1989).
A number of papers have drawn attention to the potential value of the linear-quadratic (LQ) model as an aid for solving problems related to the „iso-effectiveness" of differing radiotherapy regimen (Dale, 1986; Dale, 1989; Dale, 1990; Dale, 1990; Fowler, 1989; Matula and Durovec, 1991). However, normal tissue responses are not governed solely by the pattern of dose delivery - they depend also on the volume of the organ irradiated. Furthermore, commonly used „reference schemes" may not represent the tolerance dose of a given tissues - they may be sub-tolerance and therefore provide an unnecessarily conservative limitation in the design of an alternative scheme.
The graphical representation of tissue response suggested by Burman et al (Burman et al, 1991;
Kutcher et al, 1991; Lyman and Wolbarst, 1989) can be used as a quantitative basis for generating analytical functions with which to describe the volume effect, and therefore offer scope for a more exact evaluation of radiobiological effects in radiation therapy.
The aim of this contribution is to give:
• a review about the current state using the Linear-quadratic model (LQ) for assessment biological effects in complex radiation therapy (brachytherapy + external beam therapy)
• introduction to the estimating of the NTCP (normal tissue complications probability including a volume factor) and the TCP (tumour control probability)
• presentation of illustrative examples of simulation of effects (through parameters BED, NTCP and TCP) for rival radiotherapy treatment protocols.

Signature: Rep Pract Oncol Radiother, 1997; 2(1) : 1-9


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