Comparison between the ideal reference dose level and the actual reference dose level from clinical 3D radiotherapy treatment plans

Autor: A. Bufacchi, Luca Marmiroli, R. Capparella, Stefania Delle Canne, R. Fragomeni, Tiziana Malatesta, L. Begnozzi, Giorgio Arcangeli
Rok vydání: 2009
Předmět:
Zdroj: Radiotherapy and Oncology. 92:68-75
ISSN: 0167-8140
Popis: Purpose Retrospective study of 3D clinical treatment plans based on radiobiological considerations in the choice of the reference dose level from tumor dose–volume histograms. Methods and materials When a radiation oncologist evaluates the 3D dose distribution calculated by a treatment planning system, a decision must be made on the percentage dose level at which the prescribed dose should be delivered. Much effort is dedicated to deliver a dose as uniform as possible to the tumor volume. However due to the presence of critical organs, the result may be a rather inhomogeneous dose distribution throughout the tumor volume. In this study we use a formulation of tumor control probability (TCP) based on the linear quadratic model and on a parameter, the F factor. The F factor allows one to write TCP, from the heterogeneous dose distribution (TCP{( e j , D j )}), as a function of TCP under condition of homogeneous irradiation of tumor volume ( V ) with dose D (TCP( V , D )). We used the expression of the F factor to calculate the "ideal" percentage dose level (i DL r ) to be used as reference level for the prescribed dose D delivery, so as to render TCP{( e j , D j )} equal to TCP( V , D ). The 3D dose distributions of 53 clinical treatment plans were re-evaluated to derive the i DL r and to compare it with the one ( D tp L ) to which the dose was actually administered. Results For the majority of prostate treatments, we observed a low overdosing following the choice of a D tp L lower than the i DL r. While for the breast and head-and-neck treatments, the method showed that in many cases we underdosed choosing a D tp L greater than the i DL r . The maximum difference between the i DL r and the D tp L was −3.24% for one of the head-and-neck treatments. Conclusions Using the TCP model, the probability of tumor control is compromised following an incorrect choice of D tp L ; so we conclude that the application of the F factor is an effective tool and clinical aid to derive the optimal reference dose level from the dose–volume histogram (DVH) of each treatment plan.
Databáze: OpenAIRE