TY  - JOUR
AU  - Puri, Tanuj
AU  - Rancati, Tiziana
AU  - Seibold, Petra
AU  - Webb, Adam
AU  - Osorio, Eliana Vasquez
AU  - Green, Andrew
AU  - Gioscio, Eliana
AU  - Azria, David
AU  - Farcy-Jacquet, Marie-Pierre
AU  - Chang-Claude, Jenny
AU  - Dunning, Alison
AU  - Lambrecht, Maarten
AU  - Avuzzi, Barbara
AU  - de Ruysscher, Dirk
AU  - Sperk, Elena
AU  - Vega, Ana
AU  - Veldeman, Liv
AU  - Rosenstein, Barry
AU  - Shortall, Jane
AU  - Kerns, Sarah
AU  - Talbot, Christopher
AU  - Morris, Andrew P
AU  - McWilliam, Alan
AU  - Hoskin, Peter
AU  - Choudhury, Ananya
AU  - West, Catharine
AU  - van Herk, Marcel
TI  - Dose-response mapping of bladder and rectum in prostate cancer patients undergoing radiotherapy with and without baseline toxicity correction.
JO  - Physics & Imaging in Radiation Oncology
VL  - 35
SN  - 2405-6316
CY  - Amsterdam [u. a.]
PB  - Elsevier Science
M1  - DKFZ-2025-01480
SP  - 100805
PY  - 2025
AB  - Radiotherapy dose-response maps (DRM) combine dose-surface maps (DSM) and toxicity outcomes to identify high-risk subregions in organ-at-risk. This study assesses the impact of baseline toxicity correction on the identification of high-risk subregions in dose-response modeling for prostate cancer patients undergoing radiotherapy.The analysis included 1808 datasets, with 589 exclusions before toxicity-specific data removal. Bladder/rectum were automatically segmented on planning computed tomography scans, DSMs unwrapped into 91x90 voxel grids, and converted to equivalent doses in 2 Gy fractions (EQD2; α/β = 1 Gy). Seventeen late toxicities were assessed with two methods: (i) baseline toxicity subtracted from the maximum of 12- and 24-months toxicity scores, dichotomized at grade 1, and (ii) maximum of 12- and 24-months toxicity scores dichotomized at grade 1. DSMs were split accordingly, and voxel-wise t-values computed using Welch's t-equation. Statistically significant voxels were identified via the 95th percentile of maximum of t-value (Tmax) distribution.Event counts with baseline correction were 82/82/286/226 for urinary tract obstruction/retention/urgency/incontinence, respectively; without baseline correction, they were 93/104/465/361. For bladder DSMs, urinary incontinence, obstruction, retention, and urgency had 1143/186, 1768/1848, 516/0, and 33/0 significant voxels without/with baseline correction. For rectum DSMs, urinary incontinence and tract obstruction had 604/0 and 1980/889 significant voxels without/with baseline correction. However, no significant associations between rectal DSMs and rectum-related toxicities were found.DRM without baseline correction appears more sensitive to high-risk subregions due to higher event counts. Non-linear toxicity grading and multivariable analysis may enhance DRM reliability.
KW  - Dose-toxicity modeling (Other)
KW  - IBDM (Other)
KW  - Organ-at-risk (Other)
KW  - Prostate cancer (Other)
KW  - Radiotherapy (Other)
KW  - VBA (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40687306
C2  - pmc:PMC12272478
DO  - DOI:10.1016/j.phro.2025.100805
UR  - https://inrepo02.dkfz.de/record/303033
ER  -