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Analysis of fractionation correction methodologies for multiple phase treatment plans in radiation therapy
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10.1118/1.4792636
/content/aapm/journal/medphys/40/3/10.1118/1.4792636
http://aip.metastore.ingenta.com/content/aapm/journal/medphys/40/3/10.1118/1.4792636

Figures

Image of FIG. 1.
FIG. 1.

Demonstration of the information flow of the two fractionation correction methods. In the left panel, the approximate fractionation correction method is shown, where fractionation correction is applied after the summation of the physical dose distributions of the different treatment phases. In the right panel, the exact fractionation correction method is shown, where fractionation correction is applied to the separate dose distributions of the different phases before their summation.

Image of FIG. 2.
FIG. 2.

(Upper diagrams) The cumulative dose volume histograms, DVH of the different targets and organs at risk are presented for the CRT and IMRT treatment plans of the prostate cancer case. The solid lines correspond to the dose distributions, which have been corrected for the fractionation effects using the exact fractionation correction method, where the separate dose distributions of the different phases were corrected for fractionation before their summation. The dashed lines correspond to the dose distributions for which the approximate fractionation correction method was applied after the summation of the separate dose distributions of the different phases. (Middle diagrams) The corresponding dose-response curves of the different tissues are presented with the mean dose to the target ( ) being the normalization unit of the dose distributions. The vertical lines represent the prescribed dose level that corresponds to the DVHs of the upper diagrams. (Lower diagrams) The total tumor control (P B), total normal tissue complication (P I), and complication-free tumor control probability (P +) curves are presented for the CRT and IMRT treatment plans using the radiobiologically effective uniform dose to the target ( ) as the normalization unit for the different dose levels. Furthermore, the dose level, which is associated with the optimum effectiveness of the corresponding dose distributions is indicated.

Image of FIG. 3.
FIG. 3.

(Upper diagrams) The cumulative dose volume histograms, DVH of the different targets and organs at risk are presented for the breast cancer case. (Middle diagrams) The corresponding dose-response curves of the different tissues are shown. (Lower diagrams) The total tumor control (P B), total normal tissue complication (P I), and complication-free tumor control probability (P +) curves are presented. Line details as in Fig. 2 .

Image of FIG. 4.
FIG. 4.

(Upper diagrams) The cumulative dose volume histograms, DVH of the different targets and organs at risk are presented for the head and neck cancer case. (Middle diagrams) The corresponding dose-response curves of the different tissues are shown. (Lower diagrams) The total tumor control (P B), total normal tissue complication (P I), and complication-free tumor control probability (P +) curves are presented. Line details as in Fig. 2 .

Image of FIG. 5.
FIG. 5.

The relative difference (in %) of different radiobiological measures of the dose distributions that were produced by applying the exact fractionation correction method from the dose distributions that were produced using the approximate fractionation correction method. The measures that are examined are the complication-free tumor control probability (P +), total tumor control (P B), total normal tissue complication (P I), radiobiologically effective uniform dose to the target and to the normal tissues ( and ). The calculations were performed for the three cancer types examined (prostate, breast, and head and neck), for the CRT and IMRT radiation modalities.

Tables

Generic image for table
TABLE I.

Summary of the model parameter values for the prostate cancer case (Refs. 21 and 25–28 ). The α/β was assumed to be 3 Gy for normal tissues and 2 Gy for the targets.

Generic image for table
TABLE II.

Summary of the model parameter values for the breast cancer case. Details as in Table I (Refs. 21, 25, 26, and 29 , and 30 ). The α/β was assumed to be 3 Gy for normal tissues and 10 Gy for the targets.

Generic image for table
TABLE III.

Summary of the model parameter values for the head and neck cancer case. Details as in Table I (Refs. 21, 25, 26, 29, and 31 , and 32 ). The α/β was assumed to be 3 Gy for normal tissues and 10 Gy for the targets.

Generic image for table
TABLE IV.

Summary of the dosimetric and radiobiological results for the prostate cancer case. Response and dose statistics are given for the CRT and IMRT treatment plans. The physical and corrected to 2 Gy per fraction (using the exact fractionation correction method) doses are given in the form of absolute values. The Δ symbol shown in the accompanying columns represents the difference of the doses that were corrected to 2 Gy per fraction using the approximate fractionation correction method from the corresponding doses that were corrected to 2 Gy per fraction using the exact fractionation correction method.

Generic image for table
TABLE V.

Summary of the dosimetric and radiobiological results for the breast cancer case. Details as in Table IV .

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TABLE VI.

Summary of the dosimetric and radiobiological results for the head and neck cancer case. Details as in Table IV .

Generic image for table
TABLE VII.

Summary of the radiobiological evaluation for the prostate, breast, and head and neck cancer cases regarding the CRT and IMRT radiation modalities.

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/content/aapm/journal/medphys/40/3/10.1118/1.4792636
2013-02-27
2014-04-20
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752b84549af89a08dbdd7fdb8b9568b5 journal.articlezxybnytfddd
Scitation: Analysis of fractionation correction methodologies for multiple phase treatment plans in radiation therapy
http://aip.metastore.ingenta.com/content/aapm/journal/medphys/40/3/10.1118/1.4792636
10.1118/1.4792636
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