Abstract
Purpose: There is growing interest about biological effective dose (BED) and its application in treatment plan evaluation due to its stronger correlation with treatment outcome. An approximate biological effective dose (BED A ) equation was introduced in order to simplify BED calculations by treatment planning systems in multi-phase treatments. The purpose of this work is to reveal its mathematical properties relative to the true, multi-phase BED (BED T ) equation. Methods : The BED T equation was derived and used to reveal the mathematical properties of BED A . MATLAB (MathWorks, Natick, MA) was used to simulate and analyze common and extreme clinical multi-phase cases. In those cases, percent error and Bland-Altman analysis were used to study the significance of the inaccuracies of BED A for different combinations of total doses, numbers of fractions, doses per fractions and α/β values. All the calculations were performed on a voxel-basis in order to study how dose distributions would affect the accuracy of BED A . Results: When the voxel dose-per-fractions (DPF) delivered by both phases are equal, BED A and BED T are equal (0% error). In heterogeneous dose distributions, which significantly vary between the phases, there are fewer occurrences of equal DPFs and hence the imprecision of BED A is greater. It was shown that as the α/β ratio increased the accuracy of BED A would improve. Examining twenty-four cases, it was shown that the range of DPF ratios for 3% P error varied from 0.32 to 7.50Gy, whereas for P error of 1% the range varied from 0.50 to 2.96Gy. Conclusion : The DPF between the different phases should be equal in order to render BED A accurate. OARs typically receive heterogeneous dose distributions hence the probability of equal DPFs is low. Consequently, the BED A equation should only be used for targets or OARs that receive uniform or very similar dose distributions by the different treatment phases. --------------------------- Cite this article as : Kauweloa KI, Gutierrez AN, Bergamo A, Stathakis S, Papaniko-laou N, Mavroidis P. Mathematical analysis of approximate biological effective dose (BED) calculation for multi-phase radiotherapy treatment plans. Int J Cancer Ther Oncol 2014; 2(2):020226. DOI: 10.14319/ijcto.0202.26
Highlights
When the voxel dose-per-fractions (DPF) delivered by both phases are equal, BEDA and BEDT are equal (0% error)
An approximate biological effective dose (BEDA) equation was introduced in order to simplify BED calculations by treatment planning systems in multi-phase treatments
In heterogeneous dose distributions, which significantly vary between the phases, there are fewer occurrences of Presenting author: Kevin Kauweloa; Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Summary
The purpose of this work is to reveal its mathematical properties relative to the true, multi-phase BED (BEDT) equation. The goal of this work was to quantitatively measure the accuracy of BEDA under many different circumstances, and reveal its potential imprecision in clinical circumstances regarding healthy organs
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