Dose-rate effects in external beam radiotherapy redux

Ling, C. Clifton; Gerweck, Leo E.; Zaider, Marco; Yorke, Ellen

doi:10.1016/j.radonc.2010.03.014

Cited by 107 publications

(88 citation statements)

References 59 publications

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“…Sørensen et al failed to identify a dose rate effect in the range of 5.01-29.91 Gy/min [21]. Likewise, Ling et al point out that the dose rate effect is governed by beamon time, not by instantaneous dose rates, which may be extremely high for a FFF linac [22]. In an earlier study at our institution (involving some of the same patients), we found that actual beam-on time for FFF lung SBRT was on the order of 2-3 minutes [14].…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy (SBRT) for Lung Malignancies: Preliminary Toxicity Results Using a Flattening Filter-free Linear Accelerator Operating at 2400 Monitor Units per Minute

Prendergast

Dobelbower

Spencer

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

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Background: Flattening filter-free (FFF) linear accelerators (linacs) are capable of delivering dose rates more than 4-times higher than conventional linacs during SBRT treatments, causing some to speculate whether the higher dose rate leads to increased toxicity owing to radiobiological dose rate effects. Despite wide clinical use of this emerging technology, clinical toxicity data for FFF SBRT are lacking. In this retrospective study, we report the acute and late toxicities observed in our lung radiosurgery experience using a FFF linac operating at 2400 MU/min.

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Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy (SBRT) for Lung Malignancies: Preliminary Toxicity Results Using a Flattening Filter-free Linear Accelerator Operating at 2400 Monitor Units per Minute

Prendergast

Dobelbower

Spencer

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

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“…Typical cancer treatments are designed to deliver about twenty different fractions, each with a dose in the order of 1 Gy [48]. Modern commercial Linacs are designed to be able to deliver up to 30 Gy min −1 with a peak dose rate of 10 6 Gy min −1 [49]. For the present work, simulations using the Monte Carlo scattering…”

Section: Fig 15mentioning

confidence: 99%

A high-energy, high-flux source of gamma-rays from all-optical non-linear Thomson scattering

Corvan

Zepf

Sarri

2016

Nuclear Instruments and Methods in Physics Research Section A:

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“…It has been suggested that one of the possible reasons for this apparent cell sparing could be the repair of sublethal damage occurring during protracted fraction delivery [39]. To partly address this potential issue, BioSuite includes the LQ-SLR model and will adjust the fraction delivery time proportionally to the fraction size.…”

Section: Radiobiological Optimisation Of Radiotherapymentioning

confidence: 99%

Radiobiologically guided optimisation of the prescription dose and fractionation scheme in radiotherapy using BioSuite

Uzan¹,

Nahum²

2012

BJR

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Objective: Radiobiological models provide a means of evaluating treatment plans. Keeping in mind their inherent limitations, they can also be used prospectively to design new treatment strategies which maximise therapeutic ratio. We propose here a new method to customise fractionation and prescription dose. Methods: To illustrate our new approach, two non-small cell lung cancer treatment plans and one prostate plan from our archive are analysed using the in-house software tool BioSuite. BioSuite computes normal tissue complication probability and tumour control probability using various radiobiological models and can suggest radiobiologically optimal prescription doses and fractionation schemes with limited toxicity. Results: Dose-response curves present varied aspects depending on the nature of each case. The optimisation process suggests doses and fractionation schemes differing from the original ones. Patterns of optimisation depend on the degree of conformality, the behaviour of the normal tissue (i.e. ''serial'' or ''parallel''), the volume of the tumour and the parameters of clonogen proliferation. Conclusion: Individualising the prescription dose and number of fractions with the help of BioSuite results in improved therapeutic ratios as evaluated by radiobiological models.

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Dose-rate effects in external beam radiotherapy redux

Cited by 107 publications

References 59 publications

Stereotactic Body Radiation Therapy (SBRT) for Lung Malignancies: Preliminary Toxicity Results Using a Flattening Filter-free Linear Accelerator Operating at 2400 Monitor Units per Minute

Stereotactic Body Radiation Therapy (SBRT) for Lung Malignancies: Preliminary Toxicity Results Using a Flattening Filter-free Linear Accelerator Operating at 2400 Monitor Units per Minute

A high-energy, high-flux source of gamma-rays from all-optical non-linear Thomson scattering

Radiobiologically guided optimisation of the prescription dose and fractionation scheme in radiotherapy using BioSuite

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