Radiobiological Model in Radiotherapy Planning for Prostate Cancer Treatment
Quantitative radiobiological models can be used to
assess the optimum clinical outcome from sophisticated therapeutic
modalities by calculating tumor control probability (TCP) and normal
tissue complication probability (NTCP). In this study two 3D-CRT
and an IMRT treatment plans were developed with an initial
prescription dose of 60 Gy in 2 Gy/fraction to prostate. Sensitivity of
TCP and Complication free tumor control probability (P+) to the
different values of α/β ratio was investigated for various prescription
doses planned to be delivered in either a fixed number of fractions (I)
or in a fixed dose per fraction (II) in each of the three different
treatment plans. High dose/fraction and high α/β value result in
comparatively smaller P+ and IMRT plans resulted in the highest P+,
mainly due to the decrease in NTCP. If α/β is lower than expected,
better tumor control can be achieved by increasing dose/fraction but
decreasing the number of fractions.
[1] Fowler, J.F., Nuclear particles in cancer treatment. Medical physics
handbooks. 1981, Bristol, UK: Adam Hilger Ltd.
[2] Hirst, D.G., The importance of radiobiology to cancer therapy: current
practice and future perspectives. Clinical Oncology, 2007. 19: p. 367-
369.
[3] Pavone-Macaluso, M., Patient selection criteria for surgery, in
Radiotherapy of prostate cancer, C. Greco and M. J. Zelefsky, Editors.
2000, Harwood Academic Publishers: Amsterdam, The Netherlands. p.
69-74.
[4] Small, W., Jr. and G. Woloschak, Introduction, in Radiation Toxicity A
Practical Guide, W. Small, Jr. and G. Woloschak, Editors. 2006,
Springer: Chicago, IL, USA.
[5] Hanks, G.E., et al., Conformal technique dose escalation for prostate
cancer: Chemical evidence of improved cancer control with higher doses
in patients with pretreatment prostate-specific antigen >10 ng/ml.
International Journal of Radiation Oncology Biology Physics, 1996. 35:
p. 861-868.
[6] Leibel, S.A., et al., Three-dimensional conformal radiation therapy in
locally advanced carcinoma of the prostate: Preliminary results of a
phase I dose-escalation study. International Journal of Radiation
Oncology Biology Physics, 1994. 28: p. 55-65.
[7] Perez, C.A., et al., Three-dimensional conformal therapy (3-D CRT) and
potential for intensity-modulated radiation therapy in localized
carcinoma of prostate. In The Theory and Practice of Intensity
Modulated Radiation Therapy. E.S. Sternick, Editor. 1997 Advanced
Medical Publishing. Madison, WI, USA. p. 199-217.
[8] Perez, C.A. and J. Michalski, Outcome of external-beam radiation
therapy for localized carcinoma of the prostate (stages T1B, T2, and T3).
in Radiotherapy of prostate cancer, C. Greco and M.J. Zelefsky, Editors.
2000, Harwood academic publishers: Amsterdam, The Netherlands. p.
155-184.
[9] del Regato, J.A., A.H. Trailins, and D.D. Pittman, Twenty years followup
of patients with inoperable cancer of the prostate (stage C) treated by
radiotherapy: Report of a national cooperative study. International
Journal of Radiation Oncology Biology Physics, 1993. 26: p. 197-201.
[10] Prado, K.L., G. Starkschall, and R. Mohan, Three-dimensional
conformal radiation therapy. , in Treatment Planning in Radiation
Oncology. F.M. Khan, Editor. 2007, Lippincott Williams & Wilkins:
Philadelphia, PA, USA. p. 116-141.
[11] Webb, S., The Physics of Conformal Radiotherapy. 1997, Bristol, UK.:
Institute of Physics Publishing.
[12] Khan, F.M., The Physics of Radiation Therapy. 3rd ed. 2003,
Philadelphia, USA.: Lippincott, Williams and Wilkins.
[13] Dong, L. and R. Mohan, Intensity-modulated radiation therapy physics
and quality assurance. in Practical essentials of intensity modulated
radiation therapy., K.S.C. Chao, Editor. 2005, Lippincott Williams &
Wilkins: Philadelphia, PA, USA. p. 1-19.
[14] Williams, M., A review of intensity modulated radiation therapy:
incorporating a report on the seventh education workshop of the
ACPSEM - ACT/NSW branch. Australasian Physical & Engineering
Sciences in Medicine, 2002. 25(3): p. 91-101.
[15] Bortfeld, T.R., J. Burkelbach, and R. Boesecke, Methods of image
reconstruction from projections applied to conformal therapy. . Physics
in Medicine and Biology, 1990. 35: p. 1423-1434.
[16] 16. Brahme, A., Optimization of stationary and moving beam radiation
therapy techniques. Radiotherapy Oncology, 1988. 12: p. 129-140.
[17] Convery, D.J. and M.E. Rosenbloom, The generation of intensity
modulated fields for conformal radiotherapy by dynamic collimation.
Physics in Medicine and Biology, 1992. 37: p. 1359-1374.
[18] Holmes, T. and T.R. Mackie, A filtered back projection dose calculation
method for inverse treatment planning. Medical Physics, 1994. 21: p.
303-313.
[19] Kallman, P., B. Lind, and A. Ekloff, Shaping of arbitrary dose
distribution by dynamic Multileaf collimation. Physics in Medicine and
Biology, 1988. 33: p. 1291-1300.
[20] Mageras, G.S. and R. Mohan, Application of fast simulated annealing to
optimization of conformal radiation treatment. Medical Physics, 1993.
20: p. 639-647.
[21] Mohan, R., G.S. Mageras, and B. Baldwin, Clinically relevant
optimization of 3D conformal treatments. Medical Physics, 1992. 20: p.
933-944.
[22] Rosen, H., R.G. Lane, and S.M. Morrill, Treatment planning
optimization using linear programming. Medical Physics, 1991. 18: p.
141-152.
[23] Webb, S., Optimization of conformal dose distributions by simulated
annealing. Physics in Medicine and Biology, 1989. 34: p. 1349-1370.
[24] Fowler, J.F., Radiobiological principles guiding the management of
prostate cancer., in Radiotherapy of Prostate Cancer., C. Greco and M.J.
Zelefsky, Editors. 2000, Harwood Academic Publishers: The
Netherlands. p. 131-145.
[25] Kutcher, G.J., Quantitative plan evaluation: TCP/NTCP models. , in 3-D
Conformal Radiotherapy A New Era in the Irradiation of Cancer, J.L.
Meyer and J.A. Purdy, Editors. 1996, Karger: Basel, Switzerland. p. 67-
80.
[26] Kutcher, G.J., Quantitative plan evaluation, in Advances in Radiation
Oncology Physics Dosimetry, Treatment Planning, and Brachytherapy.,
J.A. Purdy, Editor. 1990, American Association of Physicists in
Medicine: Kansas, USA. p. 998-1021.
[27] Haken, R.K.T. and M.L. Kessler, Quantitative tools for plan evaluation,
in General Practice of Radiation Oncology Physics in the 21st Century.,
A.S. Shiu and D.E. Mellenberg, Editors. 2000, Medical Physics
Publishing: Illinois, USA. p. 17-36.
[28] Niemierko, A., Current status of TCP and NTCP calculations, in 3-D
Conformal and Intensity Modulated Radiation Therapy: Physics &
Clinical Applications. , J.A. Purdy, et al., Editors. 2001, Advanced
Medical Publishing: Madison, WI, USA. p. 95-111.
[29] Wigg, D.R., Applied Radiobiology and Bioeffect Planning. 1st ed. 2001,
Madison, Wisconsin, USA: Medical Physics Publishing.
[30] Tubiana, M., J. Dutreix, and A. Wambersie, Introduction to
Radiobiology. 1990, Bristol: Taylor & Francis. 97-104.
[31] Barendsen, G.W., Dose fractionation, dose rate and iso-effect
relationships for normal tissue responses. International Journal of
Radiation Oncology Biology Physics, 1982. 8: p. 1981-1997.
[32] Dale, R.G., The application of the linear-quadratic dose-effect equation
to fractionated and protracted radiotherapy. British Journal of
Radiology, 1985. 58: p. 515-528.
[33] Fowler, J.F., The linear quadratic formula and progress in fractionated
radiotherapy: a review. British Journal of Radiology, 1989. 62: p. 679-
694.
[34] Brahme, A., J. Nilsson, and D. Belkic, Biologically optimized radiation
therapy. Acta Oncologica, 2001. 40(6): p. 725-734. [35] Agren, A.K., A. Brahme, and I. Turesson, Optimization of
uncomplicated control for head and neck tumors. International Journal of
Radiation Oncology Biology Physics, 1990. 19(4): p. 1077-85.
[36] Kallman, P., A. Agren, and A. Brahme, Tumor and normal tissue
responses to fractionated non uniform dose delivery. International
Journal of Radiation Biology 1992. 62(2): p. 249-262.
[37] International Commission on Radiation Units and Measurements
(ICRU) Report 50, Prescribing, Recording, and Reporting Photon Beam
Therapy 1993: Bethesda, MD, USA.
[38] International Commission on Radiation Units and Measurements
(ICRU) Report 62, Prescribing, Recording, and Reporting Photon Beam
Therapy (Supplement to ICRU Report 50). 1999: Bethesda, MD, USA.
[39] McKenzie, A., M. van Herk, and B. Mijnheer, Margins for geometric
uncertainty around organs at risk in radiotherapy. Radiotherapy
Oncology, 2002. 62: p. 299-307.
[40] Muren, L.P., R. Ekerold, and Y. Kvinnsland, On the use of margins for
geometrical uncertainties around the rectum in radiotherapy planning.
Radiotherapy Oncology, 2004. 70: p. 11-19.
[41] Stroom, J.C. and B.J.M. Heijmen, Limitations of the planning organ at
risk volume (PRV) concept. International Journal of Radiation Oncology
Biology Physics, 2006. 66(1): p. 279-286.
[42] Goitien, M., M. Abrahams, and D.R. Rowell, Multidimensional
treatment planning: II. Beam's eye view, back projection, and projection
through CT sections. International Journal of Radiation Oncology
Biology Physics, 1983. 9: p. 789-797.
[43] Bortfeld, T., IMRT: a review and preview. Physics in Medicine and
Biology, 2006. 51: p. R363-R379.
[44] Boyer, A.L., Intensity modulated radiation therapy, in Treatment
Planning In Radiation Oncology, F.M. Khan, Editor. 2007, Lippincott
Williams & Wilkins: Philadelphia, PA, USA. p. 142-165.
[45] Intensity Modulated Radiation Therapy Collaborative Working Group,
Intensity-modulated radiotherapy: current status and issues of interest.
International Journal of Radiation Oncology Biology Physics, 2001.
51(4): p. 880-914.
[46] Purdy, J.A., The development of intensity modulated radiation therapy,
in The Theory & Practice of Intensity Modulated Radiation Therapy,
E.S. Sternick, and Editor. 1997, Advanced Medical Publishing:
Madison, WI, USA. p. 1-15.
[47] Peterson, L., Intensity modulated radiation therapy update. Trends in
Medicine, 2003. March: p. 1-3.
[48] Purdy, J.A., Volume and dose specification for three-dimensional
conformal radiotherapy. , in 3D Radiation Treatment Planning and
Conformal Therapy, J.A. Purdy and B. Emami, Editors. 1995, Medical
Physics Publishing: Madison, Wisconsin, USA. p. 11-14.
[49] Purdy, J.A., Dose volume specification: new challenges with intensitymodulated
radiation therapy Seminars in Radiation Oncology, 2002. 12:
p. 199-209.
[50] Lof, J., Development of a general framework for optimization of
radiation therapy. 2000, Stockholm University: Stockholm.
[51] McAneney, H. and S.F.C. O'Rourke, Investigation of various growth
mechanisms of solid tumor growth within the linear-quadratic model for
radiotherapy. Physics in Medicine and Biology, 2007. 52: p. 1039-1054.
[52] Fowler, J.F., The radiobiology of prostate cancer including new aspects
of fractionated radiotherapy. . Acta Oncologica, 2005. 44: p. 265-276.
[53] Williams, S.G., et al., Use of individual fraction size data from 3756
patients to directly determine the a/b ratio of prostate cancer. .
International Journal of Radiation Oncology Biology Physics, 2007.
68(1): p. 24-33.
[54] Garcia, L.M., D.E. Wilkins, and G.P. Raaphorst, a/b ratio: a dose range
dependence study. International Journal of Radiation Oncology Biology
Physics, 2007. 67(2): p. 587-593.
[55] Koukourakis, M.I., et al., Biological dose volume histograms during
conformal hypofractionated accelerated radiotherapy for prostate cancer.
Medical Physics, 2007. 34(1): p. 76-80.
[56] Brenner, D.J. and E.J. Hall, Fractionation and protraction for
radiotherapy of prostate carcinoma. International Journal of Radiation
Oncology Biology Physics, 1999. 43(5): p. 1095-1101.
[57] King, C.R. and C.S. Mayo, Letter to the Editor. Is the prostate a/b ratio
of 1.5 from Benner and Hall a modeling artifact? International Journal of
Radiation Oncology Biology Physics, 2000. 47(2): p. 536-539.
[58] King, C.R., T.A. DiPetrillo, and D.E. Wazer, Optimal radiotherapy for
prostate cancer: predictions for conventional external beam, IMRT, and
brachytherapy from radiobiologic models. International Journal of
Radiation Oncology Biology Physics, 2000. 46(1): p. 165-172.
[59] Fowler, J., R. Chappell, and M. Ritter, Is a/b for prostate tumors really
low? International Journal of Radiation Oncology Biology Physics,
2001. 50(4): p. 1021-1031.
[60] King, C.R. and J.F. Fowler, A simple analytic derivation suggests that
prostate cancer alpha/beta ratio is low. International Journal of Radiation
Oncology Biology Physics, 2001. 51(1): p. 213-214.
[61] Brenner, D.J., et al., Direct evidence that prostate tumors show high
sensitivity to fractionation (low alpha/beta ratio), similar to lateresponding
normal tissue. International Journal of Radiation Oncology
Biology Physics, 2002. 52: p. 6-13.
[62] Wang, J.Z., M. Guerrero, and X.A. Li, How low is the a/b ratio for
prostate cancer? . International Journal of Radiation Oncology Biology
Physics, 2005. 55: p. 194-203.
[63] Kal, H.B. and M. P. van Gellekom, How low is the alpha/beta ratio for
prostate cancer? International Journal of Radiation Oncology Biology
Physics, 2003. 57: p. 1116-1121.
[64] Fowler, J.F., Development of radiobiology for oncology - a personal
view. Physics in Medicine and Biology, 2006. 51: p. R263-R286.
[65] Nahum, A.E., et al., Incorporating clinical measurements of hypoxia into
tumor local control modeling of prostate cancer: Implications for the
alpha/beta ratio. International Journal of Radiation Oncology Biology
Physics, 2003. 57: p. 391-401.
[1] Fowler, J.F., Nuclear particles in cancer treatment. Medical physics
handbooks. 1981, Bristol, UK: Adam Hilger Ltd.
[2] Hirst, D.G., The importance of radiobiology to cancer therapy: current
practice and future perspectives. Clinical Oncology, 2007. 19: p. 367-
369.
[3] Pavone-Macaluso, M., Patient selection criteria for surgery, in
Radiotherapy of prostate cancer, C. Greco and M. J. Zelefsky, Editors.
2000, Harwood Academic Publishers: Amsterdam, The Netherlands. p.
69-74.
[4] Small, W., Jr. and G. Woloschak, Introduction, in Radiation Toxicity A
Practical Guide, W. Small, Jr. and G. Woloschak, Editors. 2006,
Springer: Chicago, IL, USA.
[5] Hanks, G.E., et al., Conformal technique dose escalation for prostate
cancer: Chemical evidence of improved cancer control with higher doses
in patients with pretreatment prostate-specific antigen >10 ng/ml.
International Journal of Radiation Oncology Biology Physics, 1996. 35:
p. 861-868.
[6] Leibel, S.A., et al., Three-dimensional conformal radiation therapy in
locally advanced carcinoma of the prostate: Preliminary results of a
phase I dose-escalation study. International Journal of Radiation
Oncology Biology Physics, 1994. 28: p. 55-65.
[7] Perez, C.A., et al., Three-dimensional conformal therapy (3-D CRT) and
potential for intensity-modulated radiation therapy in localized
carcinoma of prostate. In The Theory and Practice of Intensity
Modulated Radiation Therapy. E.S. Sternick, Editor. 1997 Advanced
Medical Publishing. Madison, WI, USA. p. 199-217.
[8] Perez, C.A. and J. Michalski, Outcome of external-beam radiation
therapy for localized carcinoma of the prostate (stages T1B, T2, and T3).
in Radiotherapy of prostate cancer, C. Greco and M.J. Zelefsky, Editors.
2000, Harwood academic publishers: Amsterdam, The Netherlands. p.
155-184.
[9] del Regato, J.A., A.H. Trailins, and D.D. Pittman, Twenty years followup
of patients with inoperable cancer of the prostate (stage C) treated by
radiotherapy: Report of a national cooperative study. International
Journal of Radiation Oncology Biology Physics, 1993. 26: p. 197-201.
[10] Prado, K.L., G. Starkschall, and R. Mohan, Three-dimensional
conformal radiation therapy. , in Treatment Planning in Radiation
Oncology. F.M. Khan, Editor. 2007, Lippincott Williams & Wilkins:
Philadelphia, PA, USA. p. 116-141.
[11] Webb, S., The Physics of Conformal Radiotherapy. 1997, Bristol, UK.:
Institute of Physics Publishing.
[12] Khan, F.M., The Physics of Radiation Therapy. 3rd ed. 2003,
Philadelphia, USA.: Lippincott, Williams and Wilkins.
[13] Dong, L. and R. Mohan, Intensity-modulated radiation therapy physics
and quality assurance. in Practical essentials of intensity modulated
radiation therapy., K.S.C. Chao, Editor. 2005, Lippincott Williams &
Wilkins: Philadelphia, PA, USA. p. 1-19.
[14] Williams, M., A review of intensity modulated radiation therapy:
incorporating a report on the seventh education workshop of the
ACPSEM - ACT/NSW branch. Australasian Physical & Engineering
Sciences in Medicine, 2002. 25(3): p. 91-101.
[15] Bortfeld, T.R., J. Burkelbach, and R. Boesecke, Methods of image
reconstruction from projections applied to conformal therapy. . Physics
in Medicine and Biology, 1990. 35: p. 1423-1434.
[16] 16. Brahme, A., Optimization of stationary and moving beam radiation
therapy techniques. Radiotherapy Oncology, 1988. 12: p. 129-140.
[17] Convery, D.J. and M.E. Rosenbloom, The generation of intensity
modulated fields for conformal radiotherapy by dynamic collimation.
Physics in Medicine and Biology, 1992. 37: p. 1359-1374.
[18] Holmes, T. and T.R. Mackie, A filtered back projection dose calculation
method for inverse treatment planning. Medical Physics, 1994. 21: p.
303-313.
[19] Kallman, P., B. Lind, and A. Ekloff, Shaping of arbitrary dose
distribution by dynamic Multileaf collimation. Physics in Medicine and
Biology, 1988. 33: p. 1291-1300.
[20] Mageras, G.S. and R. Mohan, Application of fast simulated annealing to
optimization of conformal radiation treatment. Medical Physics, 1993.
20: p. 639-647.
[21] Mohan, R., G.S. Mageras, and B. Baldwin, Clinically relevant
optimization of 3D conformal treatments. Medical Physics, 1992. 20: p.
933-944.
[22] Rosen, H., R.G. Lane, and S.M. Morrill, Treatment planning
optimization using linear programming. Medical Physics, 1991. 18: p.
141-152.
[23] Webb, S., Optimization of conformal dose distributions by simulated
annealing. Physics in Medicine and Biology, 1989. 34: p. 1349-1370.
[24] Fowler, J.F., Radiobiological principles guiding the management of
prostate cancer., in Radiotherapy of Prostate Cancer., C. Greco and M.J.
Zelefsky, Editors. 2000, Harwood Academic Publishers: The
Netherlands. p. 131-145.
[25] Kutcher, G.J., Quantitative plan evaluation: TCP/NTCP models. , in 3-D
Conformal Radiotherapy A New Era in the Irradiation of Cancer, J.L.
Meyer and J.A. Purdy, Editors. 1996, Karger: Basel, Switzerland. p. 67-
80.
[26] Kutcher, G.J., Quantitative plan evaluation, in Advances in Radiation
Oncology Physics Dosimetry, Treatment Planning, and Brachytherapy.,
J.A. Purdy, Editor. 1990, American Association of Physicists in
Medicine: Kansas, USA. p. 998-1021.
[27] Haken, R.K.T. and M.L. Kessler, Quantitative tools for plan evaluation,
in General Practice of Radiation Oncology Physics in the 21st Century.,
A.S. Shiu and D.E. Mellenberg, Editors. 2000, Medical Physics
Publishing: Illinois, USA. p. 17-36.
[28] Niemierko, A., Current status of TCP and NTCP calculations, in 3-D
Conformal and Intensity Modulated Radiation Therapy: Physics &
Clinical Applications. , J.A. Purdy, et al., Editors. 2001, Advanced
Medical Publishing: Madison, WI, USA. p. 95-111.
[29] Wigg, D.R., Applied Radiobiology and Bioeffect Planning. 1st ed. 2001,
Madison, Wisconsin, USA: Medical Physics Publishing.
[30] Tubiana, M., J. Dutreix, and A. Wambersie, Introduction to
Radiobiology. 1990, Bristol: Taylor & Francis. 97-104.
[31] Barendsen, G.W., Dose fractionation, dose rate and iso-effect
relationships for normal tissue responses. International Journal of
Radiation Oncology Biology Physics, 1982. 8: p. 1981-1997.
[32] Dale, R.G., The application of the linear-quadratic dose-effect equation
to fractionated and protracted radiotherapy. British Journal of
Radiology, 1985. 58: p. 515-528.
[33] Fowler, J.F., The linear quadratic formula and progress in fractionated
radiotherapy: a review. British Journal of Radiology, 1989. 62: p. 679-
694.
[34] Brahme, A., J. Nilsson, and D. Belkic, Biologically optimized radiation
therapy. Acta Oncologica, 2001. 40(6): p. 725-734. [35] Agren, A.K., A. Brahme, and I. Turesson, Optimization of
uncomplicated control for head and neck tumors. International Journal of
Radiation Oncology Biology Physics, 1990. 19(4): p. 1077-85.
[36] Kallman, P., A. Agren, and A. Brahme, Tumor and normal tissue
responses to fractionated non uniform dose delivery. International
Journal of Radiation Biology 1992. 62(2): p. 249-262.
[37] International Commission on Radiation Units and Measurements
(ICRU) Report 50, Prescribing, Recording, and Reporting Photon Beam
Therapy 1993: Bethesda, MD, USA.
[38] International Commission on Radiation Units and Measurements
(ICRU) Report 62, Prescribing, Recording, and Reporting Photon Beam
Therapy (Supplement to ICRU Report 50). 1999: Bethesda, MD, USA.
[39] McKenzie, A., M. van Herk, and B. Mijnheer, Margins for geometric
uncertainty around organs at risk in radiotherapy. Radiotherapy
Oncology, 2002. 62: p. 299-307.
[40] Muren, L.P., R. Ekerold, and Y. Kvinnsland, On the use of margins for
geometrical uncertainties around the rectum in radiotherapy planning.
Radiotherapy Oncology, 2004. 70: p. 11-19.
[41] Stroom, J.C. and B.J.M. Heijmen, Limitations of the planning organ at
risk volume (PRV) concept. International Journal of Radiation Oncology
Biology Physics, 2006. 66(1): p. 279-286.
[42] Goitien, M., M. Abrahams, and D.R. Rowell, Multidimensional
treatment planning: II. Beam's eye view, back projection, and projection
through CT sections. International Journal of Radiation Oncology
Biology Physics, 1983. 9: p. 789-797.
[43] Bortfeld, T., IMRT: a review and preview. Physics in Medicine and
Biology, 2006. 51: p. R363-R379.
[44] Boyer, A.L., Intensity modulated radiation therapy, in Treatment
Planning In Radiation Oncology, F.M. Khan, Editor. 2007, Lippincott
Williams & Wilkins: Philadelphia, PA, USA. p. 142-165.
[45] Intensity Modulated Radiation Therapy Collaborative Working Group,
Intensity-modulated radiotherapy: current status and issues of interest.
International Journal of Radiation Oncology Biology Physics, 2001.
51(4): p. 880-914.
[46] Purdy, J.A., The development of intensity modulated radiation therapy,
in The Theory & Practice of Intensity Modulated Radiation Therapy,
E.S. Sternick, and Editor. 1997, Advanced Medical Publishing:
Madison, WI, USA. p. 1-15.
[47] Peterson, L., Intensity modulated radiation therapy update. Trends in
Medicine, 2003. March: p. 1-3.
[48] Purdy, J.A., Volume and dose specification for three-dimensional
conformal radiotherapy. , in 3D Radiation Treatment Planning and
Conformal Therapy, J.A. Purdy and B. Emami, Editors. 1995, Medical
Physics Publishing: Madison, Wisconsin, USA. p. 11-14.
[49] Purdy, J.A., Dose volume specification: new challenges with intensitymodulated
radiation therapy Seminars in Radiation Oncology, 2002. 12:
p. 199-209.
[50] Lof, J., Development of a general framework for optimization of
radiation therapy. 2000, Stockholm University: Stockholm.
[51] McAneney, H. and S.F.C. O'Rourke, Investigation of various growth
mechanisms of solid tumor growth within the linear-quadratic model for
radiotherapy. Physics in Medicine and Biology, 2007. 52: p. 1039-1054.
[52] Fowler, J.F., The radiobiology of prostate cancer including new aspects
of fractionated radiotherapy. . Acta Oncologica, 2005. 44: p. 265-276.
[53] Williams, S.G., et al., Use of individual fraction size data from 3756
patients to directly determine the a/b ratio of prostate cancer. .
International Journal of Radiation Oncology Biology Physics, 2007.
68(1): p. 24-33.
[54] Garcia, L.M., D.E. Wilkins, and G.P. Raaphorst, a/b ratio: a dose range
dependence study. International Journal of Radiation Oncology Biology
Physics, 2007. 67(2): p. 587-593.
[55] Koukourakis, M.I., et al., Biological dose volume histograms during
conformal hypofractionated accelerated radiotherapy for prostate cancer.
Medical Physics, 2007. 34(1): p. 76-80.
[56] Brenner, D.J. and E.J. Hall, Fractionation and protraction for
radiotherapy of prostate carcinoma. International Journal of Radiation
Oncology Biology Physics, 1999. 43(5): p. 1095-1101.
[57] King, C.R. and C.S. Mayo, Letter to the Editor. Is the prostate a/b ratio
of 1.5 from Benner and Hall a modeling artifact? International Journal of
Radiation Oncology Biology Physics, 2000. 47(2): p. 536-539.
[58] King, C.R., T.A. DiPetrillo, and D.E. Wazer, Optimal radiotherapy for
prostate cancer: predictions for conventional external beam, IMRT, and
brachytherapy from radiobiologic models. International Journal of
Radiation Oncology Biology Physics, 2000. 46(1): p. 165-172.
[59] Fowler, J., R. Chappell, and M. Ritter, Is a/b for prostate tumors really
low? International Journal of Radiation Oncology Biology Physics,
2001. 50(4): p. 1021-1031.
[60] King, C.R. and J.F. Fowler, A simple analytic derivation suggests that
prostate cancer alpha/beta ratio is low. International Journal of Radiation
Oncology Biology Physics, 2001. 51(1): p. 213-214.
[61] Brenner, D.J., et al., Direct evidence that prostate tumors show high
sensitivity to fractionation (low alpha/beta ratio), similar to lateresponding
normal tissue. International Journal of Radiation Oncology
Biology Physics, 2002. 52: p. 6-13.
[62] Wang, J.Z., M. Guerrero, and X.A. Li, How low is the a/b ratio for
prostate cancer? . International Journal of Radiation Oncology Biology
Physics, 2005. 55: p. 194-203.
[63] Kal, H.B. and M. P. van Gellekom, How low is the alpha/beta ratio for
prostate cancer? International Journal of Radiation Oncology Biology
Physics, 2003. 57: p. 1116-1121.
[64] Fowler, J.F., Development of radiobiology for oncology - a personal
view. Physics in Medicine and Biology, 2006. 51: p. R263-R286.
[65] Nahum, A.E., et al., Incorporating clinical measurements of hypoxia into
tumor local control modeling of prostate cancer: Implications for the
alpha/beta ratio. International Journal of Radiation Oncology Biology
Physics, 2003. 57: p. 391-401.
@article{"International Journal of Medical, Medicine and Health Sciences:70038", author = "Pradip Deb", title = "Radiobiological Model in Radiotherapy Planning for Prostate Cancer Treatment", abstract = "Quantitative radiobiological models can be used to
assess the optimum clinical outcome from sophisticated therapeutic
modalities by calculating tumor control probability (TCP) and normal
tissue complication probability (NTCP). In this study two 3D-CRT
and an IMRT treatment plans were developed with an initial
prescription dose of 60 Gy in 2 Gy/fraction to prostate. Sensitivity of
TCP and Complication free tumor control probability (P+) to the
different values of α/β ratio was investigated for various prescription
doses planned to be delivered in either a fixed number of fractions (I)
or in a fixed dose per fraction (II) in each of the three different
treatment plans. High dose/fraction and high α/β value result in
comparatively smaller P+ and IMRT plans resulted in the highest P+,
mainly due to the decrease in NTCP. If α/β is lower than expected,
better tumor control can be achieved by increasing dose/fraction but
decreasing the number of fractions.", keywords = "Linear Quadratic Model, TCP, NTCP, α/β ratio.", volume = "8", number = "10", pages = "759-13", }
