Radiobiological evaluation considering the treatment time with stereotactic radiosurgery for brain metastases

Author:

Nakano Hisashi12ORCID,Takizawa Takeshi34,Kawahara Daisuke5,Tanabe Satoshi1,Utsunomiya Satoru6,Kaidu Motoki4,Maruyama Katsuya3,Takeuchi Shigekazu7,Onda Kiyoshi7,Koizumi Masahiko2,Nishio Teiji2,Ishikawa Hiroyuki4

Affiliation:

1. Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan

2. Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita-shi, Osaka, Japan

3. Department of Radiation Oncology, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata-shi, Niigata, Japan

4. Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan

5. Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi, Hiroshima, Japan

6. Department of Radiological Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, Japan

7. Department of Neurosurgery, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata-shi, Niigata, Japan

Abstract

Objective: We evaluated the radiobiological effect of the irradiation time with the interruption time of stereotactic radiosurgery (SRS) using CyberKnife® (CK) systemfor brain metastases. Methods: We used the DICOM data and irradiation log file of the 10 patients with brain metastases from non–small-cell lung cancer (NSCLC) who underwent brain SRS. We defined the treatment time as the sum of the dose–delivery time and the interruption time during irradiations, and we used a microdosimetric kinetic model (MKM) to evaluate the radiobiological effects of the treatment time. The biological parameters, i.e. α0, β0, and the DNA repair constant rate (a + c), were acquired from NCI-H460 cell for the MKM. We calculated the radiobiological dose for the gross tumor volume (GTVbio) to evaluate the treatment time’s effect compared with no treatment time as a reference. The D95 (%) and the Radiation Therapy Oncology Group conformity index (RCI) and Paddick conformity index (PCI) were calculated as dosimetric indices. We used several DNA repair constant rates (a + c) (0.46, 1.0, and 2.0) to assess the radiobiological effect by varying the DNA repair date (a + c) values. Results: The mean values of D95 (%), RCI, and PCI for GTVbio were 98.8%, 0.90, and 0.80, respectively, and decreased with increasing treatment time. The mean values of D95 (%), RCI, and PCI of GTVbio at 2.0 (a+c) value were 94.9%, 0.71, and 0.49, respectively. Conclusion: The radiobiological effect of the treatment time on tumors was accurately evaluated with brain SRS using CK. Advances in knowledge: There has been no published investigation of the radiobiological impact of the longer treatment time with multiple interruptions of SRS using a CK on the target dose distribution in a comparison with the use of a linac. Radiobiological dose assessment that takes into account treatment time in the physical dose in this study may allow more accurate dose assessment in SRS for metastatic brain tumors using CK.

Publisher

British Institute of Radiology

Subject

Materials Chemistry,Economics and Econometrics,Media Technology,Forestry

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