Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an Introduction to the Scientific Issues

Overview

Journal Int J Radiat Oncol Biol Phys

Specialties Oncology
Radiology

Date 2010 Feb 23

PMID 20171515

Citations 389

Authors

Soren M Bentzen

Louis S Constine

Joseph O Deasy

Avi Eisbruch

Andrew Jackson

Lawrence B Marks

Randall K Ten Haken

Ellen D Yorke

Affiliations

Soon will be listed here.

Abstract

Advances in dose-volume/outcome (or normal tissue complication probability, NTCP) modeling since the seminal Emami paper from 1991 are reviewed. There has been some progress with an increasing number of studies on large patient samples with three-dimensional dosimetry. Nevertheless, NTCP models are not ideal. Issues related to the grading of side effects, selection of appropriate statistical methods, testing of internal and external model validity, and quantification of predictive power and statistical uncertainty, all limit the usefulness of much of the published literature. Synthesis (meta-analysis) of data from multiple studies is often impossible because of suboptimal primary analysis, insufficient reporting and variations in the models and predictors analyzed. Clinical limitations to the current knowledge base include the need for more data on the effect of patient-related cofactors, interactions between dose distribution and cytotoxic or molecular targeted agents, and the effect of dose fractions and overall treatment time in relation to nonuniform dose distributions. Research priorities for the next 5-10 years are proposed.

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