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Abstract
This study aims to compare the radiobiological response of two stereotactic body radiotherapy (SBRT) schedules for patients with stage I peripheral non-small cell lung cancer (NSCLC) using radiobiological modeling methods. Volumetric modulated arc therapy (VMAT)-based SBRT plans were designed using two dose schedules of 1 × 34 Gy (34 Gy in 1 fraction) and 4 × 12 Gy (48 Gy in 4 fractions) for 19 patients diagnosed with primary stage I NSCLC. Dose to the gross target volume (GTV), planning target volume (PTV), lung and chest wall (CW) were converted to biologically equivalent dose in 2 Gy fraction (EQD2) for comparison. Five different radiobiological models were employed to predict the tumor control probability (TCP) value. Three additional models were utilized to estimate the normal tissue complication probability (NTCP) value for the lung and the modified equivalent uniform dose (mEUD) value to the CW. Our result indicates that the 1 × 34 Gy dose schedule provided a higher EQD2 dose to the tumor, lung and CW. Radiobiological modeling revealed that the TCP value for the tumor, NTCP value for the lung and mEUD value for the CW were 7.4% (in absolute value), 7.2% (in absolute value) and 71.8% (in relative value) higher on average, respectively, using the 1 × 34 Gy dose schedule.
Highlights
Stereotactic body radiation therapy (SBRT) is an effective and well-tolerated noninvasive treatment for patients with medically inoperable non-small cell lung cancer (NSCLC) [1,2,3]
This study aims to compare the radiobiological response of two stereotactic body radiotherapy (SBRT) schedules for patients with stage I peripheral non-small cell lung cancer (NSCLC) using radiobiological modeling methods
Our analysis of the dose response for stage I NSCLC using radiobiological modeling revealed that the tumor control probability (TCP) value for the tumor was 7.4% higher with the 1 × 34 Gy dose schedule
Summary
Stereotactic body radiation therapy (SBRT) is an effective and well-tolerated noninvasive treatment for patients with medically inoperable non-small cell lung cancer (NSCLC) [1,2,3]. SBRT treatment for NSCLC has offered encouraging outcomes, investigations into the benefits of single and multiple dose schedules remain ongoing [7, 8]. Radiobiological modeling is a method used to simulate the treatment outcome of the tumor and normal tissues using mathematical calculations with parameters generated from fitting the clinical trials. This method has the advantage of linking the dosimetric variation with radiobiological responses and was recently used to predict the feasibility of dose escalation for esophageal cancer and primary prostate cancer [9, 10]
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