Author: Derek A. Fiedler, Nixon Gutierrez, Quyen L. Jones, Zejian Liu, Tatsiana Reynolds 👨🔬
Affiliation: Texas Oncology, Minnesota Oncology, US Oncology 🌍
Purpose: Optimize patient safety and treatment efficacy during radiation re-treatment planning. Provide a comprehensive comparison of the methods by focusing on their applicability, accuracy, and limitations in clinical settings.
Methods: This study evaluates three practical approaches to managing dose accumulation in terms of biological effective dose (BED) calculations, equivalent dose in 2 Gy fractions (EQD2) and tissue recovery factors, aiming to optimize patient safety and treatment efficacy during radiation re-treatments. Dose accumulation is evaluated thru use of table-based DVH obtained values converted with an excel worksheet, 3D-Rigid registration dose mapping, and 3D-Deformable registration dose mapping. Also provide guidance with respect to the validations and commissioning necessary for the applications of 3D image registration and dose mapping modalities.
Results: These findings reveal significant variations in how these methods handle the complexities of dose accumulation, highlighting the need for careful selection based on specific clinical scenarios. Additionally, we discuss the implications of these methods for treatment planning and their potential to improve patient outcomes by minimizing the risks of normal tissue damage while achieving tumor dose coverage objectives.
Conclusion: 3D-EQD2 Deformable registration dose mapping can show improved accuracy when confidence with respect to tissue deformation is achieved, as comparing to Rigid registration dose mapping and Excel worksheet in evaluating normal tissue damage. Use of 3D dose mapping is superior to non-localized DVH table-based calculations in all reirradiation review settings. This study underscores the importance of continued research and refinement in the methodologies employed for dose accumulation in radiation re-treatments, advocating for tailored approaches that align with individual patient needs and clinical objectives.