论文标题
评估早期NSCLC和脑转移的剂量反应曲线中间接损伤和损伤饱和效应
Evaluation of indirect damage and damage saturation effects in dose-response curves of hypofractionated radiotherapy of early-stage NSCLC and brain metastases
论文作者
论文摘要
背景和目的:研究通过SBRT/SRS处理对早期NSCLC和脑转移的SBRT/SRS处理获得的间接损伤和损伤饱和对肿瘤控制的可能贡献。方法和材料:我们已经构建了早期NSCLC和脑转移剂量反应的数据集。这些数据根据线性季度(LQ),线性季度线性(LQL)和LQ模型的现象学修饰拟合到模型,以解释间接的细胞损伤。我们使用Akaike信息标准形式主义来比较性能,并研究了结果的稳定性与拟合参数的变化和剂量/TCP值的扰动。 结果:在NSCLC中,一种经过beta期限增加的LQ模型随剂量增加的收益最佳,最适合$α$/$β$ = 10 Gy。只有包括非常快速的加速增殖或低$α$/$β$值的包括可以消除这种优势。在大脑中,LQL模型产生的最佳状态,排名不受拟合参数或剂量/TCP扰动的变化的影响。 结论:对于$α$/$β$ = 10 Gy,一种经过beta期限增加的LQ模型随剂量增加提供了更好的适合NSCLC剂量 - 响应曲线。对于脑转移,LQL提供最佳拟合度。这可能被解释为NSCLC中间接损害的暗示,而脑转移的损伤饱和度。 NSCLC的结果在很大程度上取决于$α$/$β$的价值,并且可能需要进一步研究,而大脑的结果显然显然很重要。我们的结果可以帮助设计改进NSCLC和脑转移的放射疗法,以避免过度/不足进行。
Background and purpose: To investigate the possible contribution of indirect damage and damage saturation to tumour control obtained with SBRT/SRS treatments for early-stage NSCLC and brain metastases. Methods and Materials: We have constructed a dataset of early-stage NSCLC and brain metastases dose-response. These data were fitted to models based on the linear-quadratic (LQ), the linear-quadratic-linear (LQL), and phenomenological modifications of the LQ-model to account for indirect cell damage. We use the Akaike-Information-Criterion formalism to compare performance, and studied the stability of the results with changes in fitting parameters and perturbations on dose/TCP values. Results: In NSCLC, a modified LQ-model with a beta-term increasing with dose yields the best-fits for $α$/$β$=10 Gy. Only the inclusion of very fast accelerated proliferation or low $α$/$β$ values can eliminate such superiority. In brain, the LQL model yields the best-fits, and the ranking is not affected by variations of fitting parameters or dose/TCP perturbations. Conclusions: For $α$/$β$=10 Gy, a modified LQ-model with a beta-term increasing with dose provides better fits to NSCLC dose-response curves. For brain metastases, the LQL provides the best fit. This might be interpreted as a hint of indirect damage in NSCLC, and damage saturation in brain metastases. The results for NSCLC are strongly dependent on the value of $α$/$β$ and may require further investigation, while those for brain seem to be clearly significant. Our results can assist in the design of improved radiotherapy for NSCLC and brain metastases, aiming at avoiding over/under-treatment.