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@ARTICLE{Her:157145,
      author       = {E. J. Her and A. Haworth and H. M. Reynolds and Y. Sun and
                      A. Kennedy and V. Panettieri and M. Bangert$^*$ and S.
                      Williams and M. A. Ebert},
      title        = {{V}oxel-level biological optimisation of prostate {IMRT}
                      using patient-specific tumour location and clonogen density
                      derived from mp{MRI}.},
      journal      = {Radiation oncology},
      volume       = {15},
      number       = {1},
      issn         = {1748-717X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2020-01431},
      pages        = {172},
      year         = {2020},
      abstract     = {This study aimed to develop a framework for optimising
                      prostate intensity-modulated radiotherapy (IMRT) based on
                      patient-specific tumour biology, derived from
                      multiparametric MRI (mpMRI). The framework included a
                      probabilistic treatment planning technique in the effort to
                      yield dose distributions with an improved expected treatment
                      outcome compared with uniform-dose planning approaches.IMRT
                      plans were generated for five prostate cancer patients using
                      two inverse planning methods: uniform-dose to the planning
                      target volume and probabilistic biological optimisation for
                      clinical target volume tumour control probability (TCP)
                      maximisation. Patient-specific tumour location and clonogen
                      density information were derived from mpMRI and geometric
                      uncertainties were incorporated in the TCP calculation.
                      Potential reduction in dose to sensitive structures was
                      assessed by comparing dose metrics of uniform-dose plans
                      with biologically-optimised plans of an equivalent level of
                      expected tumour control.The planning study demonstrated
                      biological optimisation has the potential to reduce expected
                      normal tissue toxicity without sacrificing local control by
                      shaping the dose distribution to the spatial distribution of
                      tumour characteristics. On average, biologically-optimised
                      plans achieved $38.6\%$ (p-value: < 0.01) and $51.2\%$
                      (p-value: < 0.01) reduction in expected rectum and bladder
                      equivalent uniform dose, respectively, when compared with
                      uniform-dose planning.It was concluded that varying the dose
                      distribution within the prostate to take account for each
                      patient's clonogen distribution was feasible. Lower doses to
                      normal structures compared to uniform-dose plans was
                      possible whilst providing robust plans against geometric
                      uncertainties. Further validation in a larger cohort is
                      warranted along with considerations for adaptive therapy and
                      limiting urethral dose.},
      cin          = {E040},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32660504},
      doi          = {10.1186/s13014-020-01568-6},
      url          = {https://inrepo02.dkfz.de/record/157145},
}