Although in the ionizing radiation field many concepts and processes are currently recognized as radiobiological, there are also probabilistic ones, and a probabilistic treatment makes a better understanding about them. The purpose of this study is to develop a new radiobiological simulator that calculates the tumor control probability (TCP) for a tumor heterogeneously irradiated from a fractioned treatment. The three possible types of cells and the results of interactions of ionizing radiation with each cell of a determined volume are analyzed. For an irradiated region with a dose per fraction d, the simulator determines the radiation biological effects using the cell kill ( K) and cell sub-lethal damage, volume, cell density, cell repair of damaged cells during the interfractions, and number of fractions. K is determined from its probabilistic complement, the cell survival ( S), described with the linear-quadratic (LQ) S(d) model as K = 1 − LQ S( d). TCP is calculated from computational simulations as in the ratio of simulations with K = 100% and their total. This application opens new avenues for theoretical and experimental investigations concerning simulations of radiation treatments, and methodologies for therapy optimizations. Our simulator represents a novel methodology as TCP is calculated without analytical formulas, but based on its own probabilistic definition.
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The current radiosensitive studies are described with linear-quadratic (LQ) cell survival (S) model for one fraction with a dose d. As result of assuming all sublethally damaged cells (SLDCs) are completely repaired during the interfractions, that is, no presence of SLDCs, the survived cells are calculated for a n-fractionated regimen with the LQ S(n,D) model. A mathematically processed subpart of LQS(n,D) is the biologically effective dose (BED) that is used for evaluating a so-called "biological dose." The interactions of ionizing radiation with a living tissue can produce partial death or sublethal damage from healthy or sublethally damaged cells. The proportions of the killed and sub-lethally damaged cells define the radiation biological effects (RBEfs). Computational simulations using RBEFs for fractionated regimens let calculating tumor control probability. While the derivation of the LQ S(n,D) considers a 100% cell repair, that is, 0% of sublethally damaged cells (SLDCs), the radiobiological simulators take into account the presence of SLDCs, as well as a cell repair <100% during the interfractions and interruption. Given "biological dose" does not exist, but RBEf, there was need for creating the BED. It is shown how some uses of BED, like the derivation of EQ2D expression, can be done directly with the LQ S(n,D).
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