Validity of bioeffect dose response models for normal tissue early and late complications of the skin

Supe, Sanjay S.; Rana, B; Jyothi, Shubha; Naveen, T; Samuel, Jacob; Solomon, J. G. R.

doi:10.1016/s1507-1367(10)60037-5

Cited by 1 publication

(2 citation statements)

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“…With decades of clinical experience, various models including the time dose fractionation (TDF) formula have been obtained and widely used to estimate the effects of fractionation. According to TDF formula, the biological equivalent dose of 8Gy/2F approximates that of 12Gy/6F [11, 12]. (2) The proposed TMI strategy will facilitate the treatment efficiency.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of a novel dose fractionation strategy in TMI/TMLI

et al. 2018

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BackgroundTo report our experience in planning and delivering total marrow irradiation (TMI) and total marrow and lymphatic irradiation (TMLI) in patients with hematologic malignancies.MethodsTwenty-seven patients undergoing bone marrow transplantation were treated with TMI/TMLI using Helical Tomotherapy (HT). All skeletal bones exclusion of the mandible comprised the treatment target volume and, for TMLI, lymph node chains, liver, spleen and/or brain were also included according to the clinical indication. Planned dose of 8Gy in 2 fractions was delivered over 1 day for TMI while 10Gy in 2 fractions BID was used for TMLI. Organs at risk (OAR) contoured included the brain, brainstem, lens, eyes, optic nerves, parotids, oral cavity, lungs, heart, liver, kidneys, stomach, small bowel, bladder and rectum. In particular, a simple method to avoid hot or cold doses in the overlapping region was implemented and the plan sum was adopted to evaluate dose inhomogeneity. Furthermore, setup errors from 54 treatments were summarized to gauge the effectiveness of immobilization.ResultsDuring the TMI/TMLI treatment, no acute adverse effects occurred during the radiation treatment. Two patients suffered nausea or vomiting right after radiation course. For the 9 patients treated with TMI, the median dose reduction of major organs varied 30–65% of the prescribed dose, substantially lower than the traditional total body irradiation (TBI). Meanwhile, average biological equivalent doses to OARs with 8Gy/2F TMI approach were not different from the conventional 12Gy/6F TMI approach. In the dose junction region, the 93% of PTV was covered by the prescribed dose without obvious hotspots. For the 27 patients, the overall setup corrections were lower than 3 mm except those in the SI direction for abdomen-pelvis region, demonstrating excellent immobilization.ConclusionThe present study confirmed the technical feasibility of HT-based TMI/TMLI delivering 8-10Gy in 2 fractions over 1 day. For patients undergoing hematopoietic cell transplantation the proposed 8Gy/2F TMI (or 10Gy/2F TMLI) strategy may be a novel approach to improve delivery efficiency, increase effective radiation dose to target while maintaining low risk of severe organ toxicities.

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Section: Discussionmentioning

confidence: 99%

“…In both scenarios, the treatments were delivered in one day with a 6-h interval between fractions. The dose fractionation was chosen based on TDF model introduced by Supe SS et al [11, 12] that 8Gy in 2 fractions BID was equivalent to 12Gy in 2Gy × 3 days BID.…”

Section: Methodsmentioning

confidence: 99%