A review of uncertainties in radiotherapy dose reconstruction and their impacts on dose–response relationships

Bezin, Julien; Allodji, Rodrigue S.; Mège, Jean-Pierre; Beldjoudi, G.; Saunier, Florian; Chavaudra, J.; Deutsch, Éric; Vathaire, Florent de; Bernier, V.; Carrié, C.; Lefkopoulos, Dimitri; Diallo, Ibrahima

doi:10.1088/1361-6498/aa575d

Cited by 26 publications

(41 citation statements)

References 99 publications

(177 reference statements)

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“…Initial cancer treatment RT records were reviewed for all cases and controls. The review of RT dose, volume, and plan followed previously published procedures . One physician reviewed the operative notes, pathology reports, radiology reports, and any significant correspondence to determine the CRC location.…”

Section: Methodsmentioning

confidence: 99%

“…One physician reviewed the operative notes, pathology reports, radiology reports, and any significant correspondence to determine the CRC location. The dosimetry system used has previously been reported . It involved the use of a voxel‐based anthropomorphic phantom library to generate a surrogate of the whole body, as a computed tomography (CT) image for each patient who received RT, matching their dimensions.…”

Section: Methodsmentioning

confidence: 99%

“…The review of RT dose, volume, and plan followed previously published procedures. 20,21 One physician reviewed the operative notes, pathology reports, radiology reports, and any significant correspondence to determine the CRC location. The dosimetry system used has previously been reported.…”

Section: Estimation Of Radiation Dosementioning

confidence: 99%

“…The dosimetry system used has previously been reported. 20,21 It involved the use of a voxel-based anthropomorphic phantom library to generate a surrogate of the whole body, as a computed tomography (CT) image for each patient who received RT, matching their dimensions. Reconstitutions of the RT beams set up on the CT phantoms were developed using the Isogray (Dosisoft, Cachan, France) treatment planning system, implementing all of the features present to help with beam placement, as if the RT was being planned today (Supporting Information Figure S1).…”

Section: Estimation Of Radiation Dosementioning

confidence: 99%

See 3 more Smart Citations

Risk of subsequent colorectal cancers after a solid tumor in childhood: Effects of radiation therapy and chemotherapy

Allodji

Haddy

Vu‐Bezin

et al. 2018

Pediatric Blood & Cancer

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Background Very few previous studies have addressed the question of colorectal cancer (CRC) after childhood cancer treatment. We aimed to quantify the roles of radiation therapy and chemotherapy agents in the occurrence of subsequent CRC. Methods A nested case–control study was conducted using 36 CRC cases and 140 controls selected from 7032 five‐year survivors of the French Childhood Cancer Survivor Study (FCCSS) cohort, treated from 1945 to 2000 in France. The radiation dose‐distribution metrics at the site of CRC and doses of individual chemotherapeutic agents were calculated. Conditional logistic regressions were performed to calculate odds ratios (ORs). Results Overall, patients who received radiotherapy with estimated dose to colon had a 4.3‐fold (95% CI, 1.3–17.6) increased risk for CRC compared with patients who did not receive radiotherapy, after adjustment for chemotherapy. This risk increased to 8.9‐fold and 19.3‐fold among patients who received radiation doses ranging from 20 to 29.99 Gy and ≥30 Gy, respectively. Our data reported a significantly elevated OR for anthracyclines, after controlling for radiotherapy and MOPP regimen. But, restricted analyses excluding patients who had received ≥30 Gy showed that only radiation doses ranging from 20 to 29.99 Gy produced a significant increase in subsequent CRC risk (OR = 7.8; 95% CI, 1.3–56.0), after controlling for anthracyclines and MOPP regimen. Conclusions The risk of subsequent CRC was significantly increased after radiation dose (even < 30 Gy). This novel finding supports the need to update monitoring guidelines for CRC to optimize the long‐term follow‐up for subsequent CRC in survivors of childhood cancer.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Estimation Of Radiation Dosementioning

confidence: 99%

Section: Estimation Of Radiation Dosementioning

confidence: 99%

See 2 more Smart Citations

Risk of subsequent colorectal cancers after a solid tumor in childhood: Effects of radiation therapy and chemotherapy

Allodji

Haddy

Vu‐Bezin

et al. 2018

Pediatric Blood & Cancer

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“…The cumulative treatment dose from previously delivered fractions can be used to support plan adaptation decisions . Among all the factors, patient anatomic variation during radiotherapy is considered to be the number one source of uncertainty for radiobiology modeling . Therefore, the reconstruction of cumulative treatment dose based on CBCT could became a prerequisite for accurate treatment outcome modeling …”

Section: Introductionmentioning

confidence: 99%

A clinical 3D/4D CBCT‐based treatment dose monitoring system

Qin

Gersten

Liang

et al. 2018

J Applied Clin Med Phys

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To monitor delivered dose and trigger plan adaptation when deviation becomes unacceptable, a clinical treatment dose (Tx‐Dose) reconstruction system based on three‐dimensional (3D)/four‐dimensional (4D)‐cone beam computed tomograpy (CBCT) images was developed and evaluated on various treatment sites, particularly for lung cancer patient treated by stereotactic body radiation therapy (SBRT). This system integrates with our treatment planning system (TPS), Linacs recording and verification system (R&V), and CBCT imaging system, consisting of three modules: Treatment Schedule Monitoring module (TSM), pseudo‐CT Generating module (PCG), and Treatment Dose Reconstruction/evaluation module (TDR). TSM watches the treatment progress in the R&V system and triggers the PCG module when new CBCT is available. PCG retrieves the CBCTs and performs planning CT to CBCT deformable registration (DIR) to generate pseudo‐CT. The 4D‐CBCT images are taken for target localization and correction in lung cancer patient before treatment. To take full advantage of the valuable information carried by 4D‐CBCT, a novel phase‐matching DIR scheme was developed to generate 4D pseudo‐CT images for 4D dose reconstruction. Finally, TDR module creates TPS scripts to automate Tx‐Dose calculation on the pseudo‐CT images. Both initial quantitative commissioning and patient‐specific qualitative quality assurance of the DIR tool were utilized to ensure the DIR quality. The treatment doses of ten patients (six SBRT‐lung, two head and neck (HN), one breast and one prostate cancer patients) were retrospectively constructed and evaluated. The target registration error (mean ± STD: 1.05 ± 1.13 mm) of the DIR tool is comparable to the interobserver uncertainty (0.88 ± 1.31 mm) evaluated by a publically available lung‐landmarks dataset. For lung SBRT patients, the D99 of the final cumulative Tx‐Dose of GTV is 93.8 ± 5.5% (83.7–100.1%) of the originally planned D99. CTV D99 decreases by 3% and mean ipsilateral parotid dose increases by 11.5% for one of the two HN patients. In conclusion, we have demonstrated the feasibility and effectiveness of a treatment dose verification system in our clinical setting.

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Accuracy and reliability of a commercial treatment planning system in nontarget regions in modern prostate radiotherapy

Danckaert

Ost

Wagter

2023

J Applied Clin Med Phys

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Background:The currently available treatment planning systems (TPSs) are neither designed nor intended for accurate dose calculations in nontarget regions. The aim of this work is to quantify the accuracy and reliability of nontarget doses calculated by a commercially available TPS. Methods: Nontarget doses calculated by the collapsed cone (CC) (v5.2) algorithm implemented in the RayStation (v6) TPS were compared to measured values. Different scenarios were investigated, from simple static fields to intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) treatment plans. Deviations and confidence limits (CLs) were calculated between results of calculations and measurements-applying both local (δ) and global (Δ) normalization-for various points of interest (POIs). Results were based on a single-institution experience for one clinical test case (prostate) and evaluated against internationally accepted criteria. Results: Overall, the TPS underestimated the nontarget dose by an average of −17.7% ± 25.3% for IMRT. Quantitatively similar results were obtained for VMAT (−17.6% ± 21.2%). POIs receiving < 5% of the prescription dose were significantly underestimated by the TPS (p-value < 0.05 for both IMRT and VMAT). Dose calculation accuracy was also determined by the contribution of secondary radiation, with measured doses for out-of -field POIs being significantly different from calculated values (p-value < 0.01 for both IMRT and VMAT). Although the CL δ in nontarget regions failed the proposed tolerance criteria (40%) for both IMRT (68.8%) and VMAT (52.6%), the CL Δ was within the tolerance limit (4%) for both treatment techniques (1.9% for IMRT and 1.3% for VMAT). No action levels (7%) were exceeded. Conclusions: Based on the currently available benchmarks our TPS is considered acceptable for clinical use, although the dose in some POIs was poorly predicted by the CC algorithm. Some areas were pointed out where TPSs and linear accelerator control systems can be improved.

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A review of uncertainties in radiotherapy dose reconstruction and their impacts on dose–response relationships

Cited by 26 publications

References 99 publications

Risk of subsequent colorectal cancers after a solid tumor in childhood: Effects of radiation therapy and chemotherapy

Risk of subsequent colorectal cancers after a solid tumor in childhood: Effects of radiation therapy and chemotherapy

A clinical 3D/4D CBCT‐based treatment dose monitoring system

Accuracy and reliability of a commercial treatment planning system in nontarget regions in modern prostate radiotherapy

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