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Optimization of the fractionated irradiation scheme considering physical doses to tumor and organ at risk based on dose-volume histograms

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Title: Optimization of the fractionated irradiation scheme considering physical doses to tumor and organ at risk based on dose-volume histograms
Authors: Sugano, Yasutaka Browse this author
Mizuta, Masahiro Browse this author
Takao, Seishin Browse this author →KAKEN DB
Shirato, Hiroki Browse this author →KAKEN DB
Sutherland, Kenneth L. Browse this author →KAKEN DB
Date, Hiroyuki Browse this author →KAKEN DB
Keywords: fractionated radiotherapy
linear-quadratic (LQ) model
universal survival curve (USC)
repopulation of tumor cells
dose-volume histogram (DVH)
Issue Date: Nov-2015
Publisher: American Institute of Physics (AIP)
Journal Title: Medical physics
Volume: 42
Issue: 11
Start Page: 6203
End Page: 6210
Publisher DOI: 10.1118/1.4931969
PMID: 26520713
Abstract: Purpose: Radiotherapy of solid tumors has been performed with various fractionation regimens such as multi- and hypofractionations. However, the ability to optimize the fractionation regimen considering the physical dose distribution remains insufficient. This study aims to optimize the fractionation regimen, in which the authors propose a graphical method for selecting the optimal number of fractions (n) and dose per fraction (d) based on dose-volume histograms for tumor and normal tissues of organs around the tumor. Methods: Modified linear-quadratic models were employed to estimate the radiation effects on the tumor and an organ at risk (OAR), where the repopulation of the tumor cells and the linearity of the dose-response curve in the high dose range of the surviving fraction were considered. The minimization problem for the damage effect on the OAR was solved under the constraint that the radiation effect on the tumor is fixed by a graphical method. Here, the damage effect on the OAR was estimated based on the dose-volume histogram. Results: It was found that the optimization of fractionation scheme incorporating the dose-volume histogram is possible by employing appropriate cell surviving models. The graphical method considering the repopulation of tumor cells and a rectilinear response in the high dose range enables them to derive the optimal number of fractions and dose per fraction. For example, in the treatment of prostate cancer, the optimal fractionation was suggested to lie in the range of 8-32 fractions with a daily dose of 2.2-6.3 Gy. Conclusions: It is possible to optimize the number of fractions and dose per fraction based on the physical dose distribution (i.e., dose-volume histogram) by the graphical method considering the effects on tumor and OARs around the tumor. This method may stipulate a new guideline to optimize the fractionation regimen for physics-guided fractionation. (C) 2015 American Association of Physicists in Medicine.
Type: article (author version)
URI: http://hdl.handle.net/2115/63686
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 伊達 広行

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