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- W3094331348 abstract "Peak dose has been used for treatment prescription in all forms of Spatially-Fractionated Radiation Therapy (SFRT) including clinical GRID and Lattice therapy and preclinical microbeam and minibeam therapy. Peak width, valley width and dose, volume-average dose, peak dose to valley dose ratio, and EUDs are also used to characterize the complex SFRT dosimetry. Currently there is a lack of understanding which of these SFRT dosimetric parameters have close correlation with a given clinical outcome and thus should be used for treatment prescription. In this preclinical study we correlate treatment responses (tumor response and body weight change, an indicator of treatment toxicity) with each of the dosimetric parameters in a carefully designed study where a large range of radiation spatial fractionation scale is used. Five study arms (uniform tumor radiation, half-tumor radiation, 2mm beam array radiation, and 0.3mm minibeam radiation) each with 20Gy average dose, a 50 Gy minibeam and untreated arms were used. A 320kV x-ray irradiator was used. Forty-two female Fischer 344 rats with fibrosarcoma tumor allografts were used. Dosimetric parameters studied are peak dose and width, valley dose and width, peak-to-valley-dose-ratio, volumetric average dose, percentage volume directly irradiated, and tumor- and normal-tissue EUD. Animal survival, tumor volume change, and body weight change (indicative of treatment toxicity) are tested for association with the dosimetric parameters using linear regression and Cox Proportional Hazards models. The dosimetric parameters most closely associated with tumor response are tumor EUD (R2 = 0.792, F-stat = 15.26*; z-test = -4.07***), valley/minimum dose (R2 = 0.764, F-stat = 12.92*; z-test = -4.34***), and percentage tumor directly irradiated (R2 = 0.715, F-stat = 10.05*; z-test = -3.84***) per the linear regression and Cox Proportional Hazards models, respectively. Tumor response is linearly proportional to valley/minimum doses and tumor EUD. Volume average dose (R2 = 0.275, F-stat = 1.514 (no sig.); z-test = -2.81**) and peak dose (R2 = 0.045, F-stat = 0.687 (not sig.); z-test = -0.786 (not sig.)) show the weakest associations to tumor response. Only the uniform radiation arm did not gain body weight post-radiation; however, body weight change in general shows weak association with all dosimetric parameters except for valley/min dose (R2 = 0.381, F-stat = 13.56**), valley width (R2 = 0.285, F-stat = 8.78**), and peak width (R2 = 0.276, F-stat = 8.38**). For a single-fraction SFRT at conventional dose rates, valley dose is closely associated with tumor treatment response. Tumor EUD, valley/min dose, and percentage tumor directly irradiated are the top three dosimetric parameters that exhibited close associations with tumor response. Peak dose showed the weakest correlation with tumor treatment response. Our study suggests that valley dose, not peak dose, should be used for SFRT treatment prescription." @default.
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- W3094331348 date "2020-11-01" @default.
- W3094331348 modified "2023-10-16" @default.
- W3094331348 title "Should We Use Peak Dose To Prescribe A Spatially-Fractionated Radiation Therapy (SFRT) Treatment?" @default.
- W3094331348 doi "https://doi.org/10.1016/j.ijrobp.2020.07.1760" @default.
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