Radiobiological Optimization in Lung Stereotactic Body Radiation Therapy: Are We Ready to Apply Radiobiological Models?
| Autor: | Lidia Strigari, Marco Maria D'Andrea, Marcello Benassi, Raffaella Marconi, Vicente Bruzzaniti, Sara Ungania, Alessandra Cacciatore, S. Strolin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Cancer Research Stereotactic body radiation therapy Computer science radiobiological modeling Predictive capability Context (language use) Treatment of lung cancer Review lung neoplasms lcsh:RC254-282 030218 nuclear medicine & medical imaging Medical physicist 03 medical and health sciences 0302 clinical medicine normal tissue complication probability medicine Medical physics Stage (cooking) Radiation treatment planning Tumor biology lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens tumor control probability stereotactic body radiotherapy Oncology 030220 oncology & carcinogenesis |
| Zdroj: | Frontiers in Oncology Frontiers in Oncology, Vol 7 (2018) |
| ISSN: | 2234-943X |
| DOI: | 10.3389/fonc.2017.00321 |
| Popis: | Lung tumors are often associated with a poor prognosis although different schedules and treatment modalities have been extensively tested in the clinical practice. The complexity of this disease and the use of combined therapeutic approaches have been investigated and the use of high dose-rates is emerging as effective strategy. Technological improvements of clinical linear accelerators allow combining high dose-rate and a more conformal dose delivery with accurate imaging modalities pre and during therapy. This paper aims at reporting the state of the art and future direction in the use of radiobiological models and radiobiological-based optimizations in the clinical practice for the treatment of lung cancer. To address this issue, a search was carried out on PubMed database to identify potential papers reporting tumor control and normal tissue complication probability (TCP and NTCP, respectively) for lung tumors. Full articles were retrieved when the abstract was considered relevant, and only papers published in English language were considered. The bibliographies of retrieved papers were also searched and relevant articles included. At the state of the art, dose-response relationships have been reported in literature for local tumor control and survival in stage III Non-Small Cell Lung Cancer (NSCLC). Due to the lack of published radiobiological models for SBRT, several authors used dose constraints and models derived for conventional fractionation schemes. Recently, several radiobiological models and parameters for SBRT have been published and could be used in prospective trials although external validations are recommended to improve the robustness of model predictive capability. Moreover, radiobiological-based functions have been used within treatment planning systems for plan optimization but the advantages of using this strategy in the clinical practice are still under discussion. Future research should be directed towards combined regimens, in order to potentially improve both local tumor control and survival. Indeed, accurate knowledge of the relevant parameters describing tumor biology and normal tissue response is mandatory to correctly address this issue. In this context, the role of medical physicists and the AAPM in the development of radiobiological models is crucial for the progress of developing specific tool for radiobiological-based optimization treatment planning. |
| Databáze: | OpenAIRE |
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