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@ARTICLE{Glowa:302993,
      author       = {C. Glowa$^*$ and M. Saager$^*$ and L. Hintz$^*$ and R.
                      Euler-Lange$^*$ and P. Peschke$^*$ and S. Brons and K. Hilt
                      and T. Friedrich and M. Scholz and H. Liew$^*$ and A.
                      Mairani and C. Karger$^*$},
      title        = {{V}ariable {R}elative {B}iological {E}ffectiveness of
                      {P}rotons in the {R}at {S}pinal {C}ord: {M}easurements and
                      {C}omparison {W}ith {M}odel {C}alculations.},
      journal      = {Advances in radiation oncology},
      volume       = {10},
      number       = {8},
      issn         = {2452-1094},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-01440},
      pages        = {101809},
      year         = {2025},
      note         = {#EA:E040#LA:E040#},
      abstract     = {To determine the relative biological effectiveness (RBE) in
                      the rat spinal cord after 6 fractions of protons as a
                      function of linear energy transfer (LET) and dose.The rat
                      spinal cord was irradiated at 4 different positions of a 6
                      cm spread-out Bragg peak using 6 fractions of protons (LET:
                      1.4, 2.7, 3.9, and 5.5 keV/µm). Dose-response curves were
                      established for the endpoint paresis grade 2, and the RBE
                      was calculated based on the dose at $50\%$ effect
                      probability. Including data with single and split doses, the
                      measured RBE values were compared with predictions from 4
                      mechanistic, 3 phenomenological, and 2 patient-derived
                      variable RBE models.With increasing LET, the dose at $50\%$
                      effect probability decreased from 51.3 Gy to 43.3 Gy,
                      resulting in a rise in the RBE from 1.11 to 1.32. The
                      biologically equivalent dose decreased markedly between the
                      2 proximal and 2 distal spinal cord positions, resulting in
                      extrapolated maximum RBE values of up to 1.87 in the limit
                      of zero dose per fraction. The α/β values ranged between
                      1.5 Gy and 4.2 Gy. At 3.9 and 5.5 keV/µm, the RBE increased
                      with decreasing dose, and at 1.8 Gy per fraction, the RBE
                      was extrapolated to 1.40 and 1.42, respectively. The
                      agreement between predicted and measured RBE varied between
                      the different models.A fixed RBE of 1.1 provides a good
                      approximation up to the center of the spread-out Bragg peak;
                      however, at 3 mm from the distal end, the RBE increases
                      markedly and may reach values above 1.4 at clinical fraction
                      schedules. Using predictions from a variable RBE model may,
                      therefore, be reasonable; however, the model and model
                      parameters should be carefully selected, ideally as a
                      consensus among the proton therapy centers.},
      cin          = {E040 / E220 / E210 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331 / I:(DE-He78)E220-20160331 /
                      I:(DE-He78)E210-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40678668},
      pmc          = {pmc:PMC12269397},
      doi          = {10.1016/j.adro.2025.101809},
      url          = {https://inrepo02.dkfz.de/record/302993},
}