Simple Summary The radiotherapy plans are usually judged using physical quantities, including dose and dose-volume values. Biological indices may also be applied for plan evaluation. A new software was developed for the quick and automatic calculation of tumor control probability (TCP) and normal tissue control probability (NTCP) from any radiation therapy plan and any fractionation scheme. Limited information has been published about the radiobiological metrics associated with gastric cancer irradiation. The new software was applied to radiobiologically compare photon plans for gastric malignancies generated with three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The IMRT and VMAT plans provided higher TCPs than 3D-CRT. They also reduced the NTCPs and the risk of late adverse effects in most of the surrounding healthy organs compared to 3D-CRT. The presented results are useful for the plan optimization and choice of the appropriate radiotherapy technique for gastric cancer. Abstract (1) Aim: This study was conducted to radiobiologically compare radiotherapy plans for gastric cancer with a newly developed software tool. (2) Methods: Treatment planning was performed on two computational phantoms simulating adult male and female patients. Three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans for gastric cancer were generated with three-photon beam energies. The equivalent uniform dose (EUD), tumor control probability (TCP) of the target and normal tissue control probability (NTCP) of eight different critical organs were calculated. A new software was employed for these calculations using the EUD-based model and dose-volume-histogram data. (3) Results: The IMRT and VMAT plan led to TCPs of 51.3–51.5%, whereas 3D-CRT gave values up to 50.2%. The intensity-modulated techniques resulted in NTCPs of (5.3 × 10−6–3.3 × 10−1)%. The corresponding NTCPs from 3D-CRT were (3.4 × 10−7–7.4 × 10−1)%. The above biological indices were automatically calculated in less than 40 s with the software. (4) Conclusions: The direct and quick radiobiological evaluation of radiotherapy plans is feasible using the new software tool. The IMRT and VMAT reduced the probability of the appearance of late effects in most of the surrounding critical organs and slightly increased the TCP compared to 3D-CRT.

/pdf/automatic-radiobiological-comparison-of-radiation-therapy-id3vav8t.pdf

Automatic Radiobiological Comparison of Radiation Therapy Plans: An Application to Gastric Cancer

Comment on Incidence risk assessment of secondary cancer due to radiotherapy of women with rectal cancer using BEIR VII, EPA, and ICRP models

With advancements in medical technology, stereotactic radiosurgery (SRS) has become an essential option for treating benign intracranial tumors. Due to its minimal side effects and high local control rate, SRS is widely applied. This paper evaluates the plan quality and secondary cancer risk (SCR) in patients with benign intracranial tumors treated with the CyberKnife M6 system. The CyberKnife M6 robotic radiosurgery system features both multileaf collimator (MLC) and IRIS variable aperture collimator systems, providing different treatment options. The study included 15 patients treated with the CyberKnife M6 system, examining the differences in plan quality and SCR between MLC and IRIS systems. Results showed that MLC and IRIS plans had equal PTV (planning target volume) coverage (98.57% vs. 98.75%). However, MLC plans demonstrated better dose falloff and conformity index (CI: 1.81 ± 0.26 vs. 1.92 ± 0.27, P = 0.025). SCR assessment indicated that MLC plans had lower cancer risk estimates, with IRIS plans having average LAR (lifetime attributable risk) and EAR (excess absolute risk) values approximately 25% higher for cancer induction and 15% higher for sarcoma induction compared to MLC plans. The study showed that increasing tumor volume increases SCR probability, but there was no significant difference between different plans in PTV and brainstem analyses.

A mini review of plan quality and secondary cancer risk in CyberKnife M6 radiosurgery for benign intracranial tumors

Background : Radiotherapy has a significant side effect known as radiation-induced secondary cancer. This study aims to evaluate the dose and secondary cancer risk for women with rectal cancer treated with three-dimensional conformal radiation therapy (3DCRT) to the organs at risk (OARs) and some sensitive organs using different types of radiation-induced cancer risk prediction models, including Biological Effects of Ionizing Radiation (BEIRVII), Environmental Protection Agency (EPA) and International Commission on Radiological Protection (ICRP)

https://journals.viamedica.pl/rpor/article/download/96870/72931

Incidence risk assessment of secondary cancer due to radiotherapy of women with rectal cancer using BEIR VII, EPA, and ICRP models

Background: Gastro-esophageal (GE) junction cancer is the fastest-growing tumor, particularly in the United States (US). Objective: This study aimed to compare dosimetric and radiobiological factors among field-in-field (FIF), three-field (3F), and four-field box (4FB) radiotherapy planning techniques for gastro-esophageal junction cancer. Material and Methods: In this experimental study, thirty patients with GE junction cancer were evaluated, and three planning techniques (field-in-field (FIF), three-field (3F), and four-field box (4FB)) were performed for each patient for a 6-MV photon beam. Dose distribution in the target volume, the monitor units (MUs) required, and the dose delivered to organs at risk (OARs) were compared for these techniques using the paired-sample t-test. Results: A significant difference was measured between the FIF and 3F techniques with respect to conformity index (CI), dose homogeneity index (HI), and tumor control probability (TCP) for the target organ, as well as the Dmean for the heart, kidneys, and liver. For the spinal cord, the FIF technique showed a slight reduction in the maximum dose compared to the other two techniques. In addition, the V20 Gy of the lungs and the normal tissue complication probability (NTCP) of all OARs were reduced with FIF method. Conclusion: The FIF technique showed better performance for treating patients with gastro-esophageal junction tumors, in terms of dose homogeneity in the target, conformity of the radiation field with the target volume, TCP, less dose to healthy organs, and fewer MU.

/pdf/assessment-of-field-in-field-3-field-and-4-field-treatment-2wi3ez6t.pdf

Assessment of Field-in-Field, 3-Field, and 4-Field Treatment Planning Methods for Radiotherapy of Gastro-Esophageal Junction Cancer

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Incidence risk assessment of secondary cancer due to radiotherapy of women with rectal cancer using BEIR VII, EPA, and ICRP models

Assessment of Field-in-Field, 3-Field, and 4-Field Treatment Planning Methods for Radiotherapy of Gastro-Esophageal Junction Cancer