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• W2022043863 abstract "Recent publications suggested that the α/β ratio could be as low as 1.5 for prostate cancer, indicating that prostate cancer control might be more sensitive to changes in the dose fractionation scheme. This also suggests that the standard fractionation scheme based on large α/β ratios may not be optimal for the radiotherapeutic management of prostate cancer. Hypo-fractionated radiotherapy for prostate cancer has received more attention recently as an alternative treatment strategy, which may lead to reduced treatment time and cost. However, hypo-fractionated radiotherapy may be more sensitive to patient variation in terms of disease control. The variation of LQ parameters α and β for a patient population may compromise the outcome of the treatment. The purpose of this study is to examine the effect of α and β variation for different patient populations on tumor control probability for standard- and hypo-fractionated radiotherapy. The generalized linear-quadratic (LQ) model was used to calculate the cell-killing efficiency of radiotherapy treatments for prostate cancer. The LQ parameters were derived from clinical data, and variations in LQ model parameters α and β were added through parameters σα and σβ, which are the standard deviations of Gaussian distributions around α0 and β0. TCD50 and TCD95, which are the required uniform doses to achieve 50% and 95% tumor control probability respectively, were compared with different α and β values and variable deviations. The tumor control probabilities (TCPs) were calculated for standard- and hypo-fractionated radiotherapy treatment for 20 IMRT patients. Our analysis showed that the TCP varied significantly with increasing σα and σβ. TCD95 always increased with σα and σβ while TCD50 remained the same (within 0.1%) for the same LQ parameters α and β. When σα varied from 0 to 30%, the TCD95 varied by up to 38% under some circumstance. For standard dose fractionation (2 Gy/fraction), more doses were required to achieve 95% TCP compared with hypo-fractionated treatment for an increasing σα (Fig. 1a). When σβ varied, TCD95 increased with σβ when fewer fractions were used (Fig. 1b) for high α/β values. For low α/β, the extra dose required to maintain 95% TCP remained relatively constant for different treatment fractions. Variations of α and β due to different patient populations have been introduced in the biological modeling of standard- and hypo-fractionated radiotherapy of prostate cancer. In general, the α term always plays an important role in cell-killing and the patient variation σα must be considered in designing a new fractionation scheme. Extra doses may be needed to maintain 95% TCP for treatment schemes different from standard fractionation, no matter α/β ratio is high or low. The β term also plays an important role in cell-killing and the effect of σβ depends on the α/β ratio. For high α/β ratio, the extra dose to keep 95% TCP varies significantly with the fractionation scheme while for low α/β ratio it is less sensitive. Assuming a low α/β ratio for prostate cancer, it is relatively safe to adopt hypo-fractionated treatment even for a significant σβ." @default.
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• W2022043863 date "2004-09-01" @default.
• W2022043863 modified "2023-09-22" @default.
• W2022043863 title "Effect of patient variation on standard- and hypo-fractionated radiotherapy of prostate cancer" @default.
• W2022043863 doi "https://doi.org/10.1016/j.ijrobp.2004.07.575" @default.
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