» Articles » PMID: 32976878

The Relative Biological Effectiveness of Carbon Ion Radiation Therapy for Early Stage Lung Cancer

Overview
Journal Radiother Oncol
Specialties Oncology
Radiology
Date 2020 Sep 25
PMID 32976878
Citations 3
Authors
Affiliations
Soon will be listed here.
Abstract

Background And Purpose: Carbon ion radiation therapy (CIRT) is recognized as an effective alternative treatment modality for early stage lung cancer, but a quantitative understanding of relative biological effectiveness (RBE) compared to photon therapy is lacking. In this work, a mechanistic tumor response model previously validated for lung photon radiotherapy was used to estimate the RBE of CIRT compared to photon radiotherapy, as a function of dose and the fractionation schedule.

Materials And Methods: Clinical outcome data of 9 patient cohorts (394 patients) treated with CIRT for early stage lung cancer, representing all published data, were included. Fractional dose, number of fractions, treatment schedule, and local control rates were used for model simulations relative to standard photon outcomes. Four parameters were fitted: α, α/β, and the oxygen enhancement ratios of cells either accessing only glucose, not oxygen (OER), or cells dying from starvation (OER). The resulting dose-response relationship of CIRT was compared with the previously determined dose-response relationship of photon radiotherapy for lung cancer, and an RBE of CIRT was derived.

Results: Best-fit CIRT parameters were: α = 1.12 Gy [95%-CI: 0.97-1.26], α/β = 23.9 Gy [95%-CI: 8.9-38.9], and the oxygen induced radioresistance of hypoxic cell populations were characterized by OER = 1.08 [95%-CI: 1.00-1.41] (cells lacking oxygen but not glucose), and OER = 1.01 [95%-CI: 1.00-1.44] (cells lacking oxygen and glucose). Depending on dose and fractionation, the derived RBE ranges from 2.1 to 1.5, with decreasing values for larger fractional dose and fewer number of fractions.

Conclusion: Fitted radiobiological parameters were consistent with known carbon in vitro radiobiology, and the resulting dose-response curve well-fitted the reported data over a wide range of dose-fractionation schemes. The same model, with only a few fitted parameters of clear mechanistic meaning, thus synthesizes both photon radiotherapy and CIRT clinical experience with early stage lung tumors.

Citing Articles

Data Science Opportunities To Improve Radiotherapy Planning and Clinical Decision Making.

Deasy J Semin Radiat Oncol. 2024; 34(4):379-394.

PMID: 39271273 PMC: 11698470. DOI: 10.1016/j.semradonc.2024.07.012.


Application of Carbon Ion and Its Sensitizing Agent in Cancer Therapy: A Systematic Review.

Wang X, Chen X, Li G, Han X, Gao T, Liu W Front Oncol. 2021; 11:708724.

PMID: 34290989 PMC: 8287631. DOI: 10.3389/fonc.2021.708724.


Carbon Ion Radiobiology.

Tinganelli W, Durante M Cancers (Basel). 2020; 12(10).

PMID: 33080914 PMC: 7603235. DOI: 10.3390/cancers12103022.

References
1.
Gueulette J, Wambersie A . Comparison of the Methods of Specifying Carbon Ion Doses at NIRS and GSI. J Radiat Res. 2007; 48 Suppl A:A97-A102. DOI: 10.1269/jrr.48.a97. View

2.
Karger C, Peschke P . RBE and related modeling in carbon-ion therapy. Phys Med Biol. 2017; 63(1):01TR02. DOI: 10.1088/1361-6560/aa9102. View

3.
Gillespie C, Chapman J, Reuvers A, Dugle D . The inactivation of Chinese hamster cells by x rays: synchronized and exponential cell populations. Radiat Res. 1975; 64(2):353-64. View

4.
Matsufuji N, Kanai T, Kanematsu N, Miyamoto T, Baba M, Kamada T . Specification of Carbon Ion Dose at the National Institute of Radiological Sciences (NIRS). J Radiat Res. 2007; 48 Suppl A:A81-6. DOI: 10.1269/jrr.48.a81. View

5.
Malaise E, Chavaudra N, TUBIANA M . The relationship between growth rate, labelling index and histological type of human solid tumours. Eur J Cancer (1965). 1973; 9(4):305-12. DOI: 10.1016/0014-2964(73)90099-6. View