Journal Article

DKFZ-2023-00634

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Do We Preserve Tumor Control Probability (TCP) in FLASH Radiotherapy? A Model-Based Analysis.

Liew, H. (First author)DKFZ* ; Mein, S.DKFZ* ; Tessonnier, T. ; Abdollahi, A.DKFZ* ; Debus, J.DKFZ* ; Dokic, I.DKFZ* ; Mairani, A.

2023
Molecular Diversity Preservation International Basel

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Please use a persistent id in citations: doi:10.3390/ijms24065118

Abstract: Reports of concurrent sparing of normal tissue and iso-effective treatment of tumors at ultra-high dose-rates (uHDR) have fueled the growing field of FLASH radiotherapy. However, iso-effectiveness in tumors is often deduced from the absence of a significant difference in their growth kinetics. In a model-based analysis, we investigate the meaningfulness of these indications for the clinical treatment outcome. The predictions of a previously benchmarked model of uHDR sparing in the 'UNIfied and VERSatile bio response Engine' (UNIVERSE) are combined with existing models of tumor volume kinetics as well as tumor control probability (TCP) and compared to experimental data. The potential TCP of FLASH radiotherapy is investigated by varying the assumed dose-rate, fractionation schemes and oxygen concentration in the target. The developed framework describes the reported tumor growth kinetics appropriately, indicating that sparing effects could be present in the tumor but might be too small to be detected with the number of animals used. The TCP predictions show the possibility of substantial loss of treatment efficacy for FLASH radiotherapy depending on several variables, including the fractionation scheme, oxygen level, and DNA repair kinetics. The possible loss of TCP should be seriously considered when assessing the clinical viability of FLASH treatments.

Keyword(s): DNA repair ; FLASH ; TCP ; UNIVERSE ; dose-rate ; ionizing radiation ; modeling ; tumor volume

Note: #EA:E210#

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Contributing Institute(s):

1. E210 KKE Translationale Radioonkologie (E210)
2. DKTK HD zentral (HD01)
3. E050 KKE Strahlentherapie (E050)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2023

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