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@ARTICLE{Liew:274491,
      author       = {H. Liew$^*$ and S. Mein$^*$ and T. Tessonnier and A.
                      Abdollahi$^*$ and J. Debus$^*$ and I. Dokic$^*$ and A.
                      Mairani},
      title        = {{D}o {W}e {P}reserve {T}umor {C}ontrol {P}robability
                      ({TCP}) in {FLASH} {R}adiotherapy? {A} {M}odel-{B}ased
                      {A}nalysis.},
      journal      = {International journal of molecular sciences},
      volume       = {24},
      number       = {6},
      issn         = {1422-0067},
      address      = {Basel},
      publisher    = {Molecular Diversity Preservation International},
      reportid     = {DKFZ-2023-00634},
      pages        = {5118},
      year         = {2023},
      note         = {#EA:E210#},
      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.},
      keywords     = {DNA repair (Other) / FLASH (Other) / TCP (Other) / UNIVERSE
                      (Other) / dose-rate (Other) / ionizing radiation (Other) /
                      modeling (Other) / tumor volume (Other)},
      cin          = {E210 / HD01 / E050},
      ddc          = {540},
      cid          = {I:(DE-He78)E210-20160331 / I:(DE-He78)HD01-20160331 /
                      I:(DE-He78)E050-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36982185},
      doi          = {10.3390/ijms24065118},
      url          = {https://inrepo02.dkfz.de/record/274491},
}