Comparison of biological functional assessment in intensity-modulated radiotherapy: two-dimensional study

Abstract

Modulated intensity dose distributions are obtained by inverse planning. It requires an inversion algorithm and an objective function that can be physical or biological. The biological objective functions aim at quantifying the probability of the favourable end of the treatment. The inversion algorithm used is analytical and is based on the mathematical analysis of the singular values decomposition. It proposes as many solutions as there are elementary beams. From the Tumour Control Probability, Normal Tissue Complication Probabilities and complication free tumour control, three biological assessment functions of the proposed solutions are compared with the least square difference between the prescribed and obtained dose distributions. We used a simplified irradiation configuration: Brahme's dose prescription (2D modelling of a prostate) and 9 beams (1D). The choice by mean of biological criterion of the optimal solution makes it possible to increase the average dose in the tumour, so as its homogeneity compared to physical optimisation. Conversely, the organs at risk are then less protected. The laying down of relevant constraints makes it possible to obtain satisfactory dose distributions. Concerning the validity of the models and data used, some limitations appear. At present time, it seems to exclude the use in clinical routine of an only biological optimisation. The future availability of new biological data will allow the development and in particular the clinical use of biological optimisation.