A generalised method for calculating repopulation-corrected tumour EQD2 values in a wide range of clinical situations, including interrupted treatments
File(s)EQD2 paper accepted version.pdf (734.25 KB)
Accepted version
Author(s)
Dale, Roger
Plataniotis, Georgios
Jones, Bleddyn
Type
Journal Article
Abstract
Any radiotherapy schedule can be characterised by its 2 Gy per fraction equivalent dose (EQD2). EQD2s are easily calculated for late-responding normal tissues but for tumours significant errors may arise if no allowance is made for any repopulation which occurs in the reference and/or the derived EQD2 schedule. This article presents a systematic approach to calculating tumour EQD2 values utilising the concept of biologically effective dose (BED) with inclusion of repopulation effects. A factor (f) is introduced which allows the inter-dependence between EQD2 and its delivery time (and, hence, the amount of repopulation involved) to be embedded within the formulation without any additional assumptions. There exists a transitional BED below which simple methods of calculating tumour EQD2 remain valid. In cases where simpler approaches are inadequate, the correct EQD2 may be determined from the reference schedule BED (BEDref) by the relationship: EQD2 = A × BEDref - B, where A and B are constants which involve the same radiobiological parameters as are conventionally used in deriving tumour BED values. Some Worked Examples illustrate application of the method to fractionated radiotherapy and indicate that there can be substantial differences with results obtained from using over-simplified approaches. Since reference BEDs are calculable for other types of radiotherapy (brachytherapy, permanent implants, high-LET applications, etc) the methodology allows estimation of tumour EQD2 values in a wide range of clinical circumstances, including cases which involve interrupted treatments.
Date Issued
2024-02-01
Date Acceptance
2024-01-07
Citation
Physica Medica: an international journal devoted to the applications of physics to medicine and biology, 2024, 118
ISSN
1120-1797
Publisher
Elsevier
Journal / Book Title
Physica Medica: an international journal devoted to the applications of physics to medicine and biology
Volume
118
Copyright Statement
© 2024 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. All rights reserved. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/38199178
PII: S1120-1797(24)00088-7
Subjects
Equivalent dose in 2Gy fractions
Linear-quadratic modelling
Tumour treatment equivalents
Publication Status
Published
Coverage Spatial
Italy
Article Number
103294
Date Publish Online
2024-01-09