Abstract
Purpose:The spatially fractionated radiation therapy (Grid therapy) is a novel technique that has been recently introduced for treatments of the patients with advanced bulky tumors. The purpose of this study is to investigate the effect of the radiation sensitivity of tumor and Grid block design on the clinical response of the Grid therapy.Methods:The Geant4 toolkit is used to simulate a Varian2100C linear accelerator with the block‐based Grid. The dose profile has been utilized to calculate the Therapeutic Ratio (TR) and Equivalent Uniform Dose (EUD) for different types of tumors. These calculations were performed with respect to their radiation sensitivities using Linear Quadratic model (LQ). Clinical responses of few hundred patients from different publications that were treated with Grid therapy, have been used to validate correlation between tumor radiation sensitivity and clinical response of Grid therapy. Moreover, the influence of Grid design on clinical response of this radiation technique was investigated with using Monte Carlo simulation of a Grid block with different hole‐diameters of 0.5 cm, 0.75 cm, 1.25 cm, and 1.5 cm. The Geometrical Sparing Factor (GSF) was considered to compare the results from different Grid designs.Results:The higher clinical response of Grid therapy for more radio‐resistant tumors was confirmed in both theoretical assumptions and clinical outcomes. In addition, the results indicate that the Grid hole diameter have more effect on increasing the TR in comparison with the hole center‐to‐center distance effect. From this Monte Carlo study, a Grid design with the hole diameter between 1.25 cm and 1.5 cm with GSF value of 0.90 is recommended.Conclusion:Grid Therapy is more effective for more radio‐resistant tumors.The optimum results of the Grid therapy depend on selection of the appropriate Grid design.This study is a first step toward clarifying some important aspects in a clinical response of spatially fractionated radiation therapy.
Published Version
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