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Title: A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy;External beam therapy; Radiopharmaceutical therapy; Three-dimensional dosimetry; Treatment planning

Abstract

Purpose: Effective cancer treatment generally requires combination therapy. The combination of external beam therapy (XRT) with radiopharmaceutical therapy (RPT) requires accurate three-dimensional dose calculations to avoid toxicity and evaluate efficacy. We have developed and tested a treatment planning method, using the patient-specific three-dimensional dosimetry package 3D-RD, for sequentially combined RPT/XRT therapy designed to limit toxicity to organs at risk. Methods and Materials: The biologic effective dose (BED) was used to translate voxelized RPT absorbed dose (D{sub RPT}) values into a normalized total dose (or equivalent 2-Gy-fraction XRT absorbed dose), NTD{sub RPT} map. The BED was calculated numerically using an algorithmic approach, which enabled a more accurate calculation of BED and NTD{sub RPT}. A treatment plan from the combined Samarium-153 and external beam was designed that would deliver a tumoricidal dose while delivering no more than 50 Gy of NTD{sub sum} to the spinal cord of a patient with a paraspinal tumor. Results: The average voxel NTD{sub RPT} to tumor from RPT was 22.6 Gy (range, 1-85 Gy); the maximum spinal cord voxel NTD{sub RPT} from RPT was 6.8 Gy. The combined therapy NTD{sub sum} to tumor was 71.5 Gy (range, 40-135 Gy) for a maximum voxel spinal cord NTD{sub sum}more » equal to the maximum tolerated dose of 50 Gy. Conclusions: A method that enables real-time treatment planning of combined RPT-XRT has been developed. By implementing a more generalized conversion between the dose values from the two modalities and an activity-based treatment of partial volume effects, the reliability of combination therapy treatment planning has been expanded.« less

Authors:
;  [1];  [2]; ; ; ; ;  [1];  [3];  [1]
  1. Johns Hopkins University, Baltimore, MD (United States)
  2. University Institute of Radiation Physics, University of Lausanne (Switzerland)
  3. York Cancer Center, York, PA (United States)
Publication Date:
OSTI Identifier:
21587623
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2010.08.022; PII: S0360-3016(10)03068-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMBINED THERAPY; DOSIMETRY; HAZARDS; NEOPLASMS; ORGANS; RADIATION DOSES; RADIOPHARMACEUTICALS; RADIOTHERAPY; SAMARIUM 153; SPINAL CORD; TOXICITY; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CENTRAL NERVOUS SYSTEM; DAYS LIVING RADIOISOTOPES; DISEASES; DOSES; DRUGS; EVEN-ODD NUCLEI; INTERMEDIATE MASS NUCLEI; ISOTOPES; LABELLED COMPOUNDS; MATERIALS; MEDICINE; NERVOUS SYSTEM; NUCLEAR MEDICINE; NUCLEI; RADIOACTIVE MATERIALS; RADIOISOTOPES; RADIOLOGY; RARE EARTH NUCLEI; SAMARIUM ISOTOPES; THERAPY

Citation Formats

Hobbs, Robert F., McNutt, Todd, Baechler, Sebastien, He Bin, Esaias, Caroline E., Frey, Eric C., Loeb, David M., Wahl, Richard L., Shokek, Ori, and Sgouros, George, E-mail: gsgouro1@jhmi.edu. A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy;External beam therapy; Radiopharmaceutical therapy; Three-dimensional dosimetry; Treatment planning. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.08.022.
Hobbs, Robert F., McNutt, Todd, Baechler, Sebastien, He Bin, Esaias, Caroline E., Frey, Eric C., Loeb, David M., Wahl, Richard L., Shokek, Ori, & Sgouros, George, E-mail: gsgouro1@jhmi.edu. A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy;External beam therapy; Radiopharmaceutical therapy; Three-dimensional dosimetry; Treatment planning. United States. doi:10.1016/j.ijrobp.2010.08.022.
Hobbs, Robert F., McNutt, Todd, Baechler, Sebastien, He Bin, Esaias, Caroline E., Frey, Eric C., Loeb, David M., Wahl, Richard L., Shokek, Ori, and Sgouros, George, E-mail: gsgouro1@jhmi.edu. Fri . "A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy;External beam therapy; Radiopharmaceutical therapy; Three-dimensional dosimetry; Treatment planning". United States. doi:10.1016/j.ijrobp.2010.08.022.
@article{osti_21587623,
title = {A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy;External beam therapy; Radiopharmaceutical therapy; Three-dimensional dosimetry; Treatment planning},
author = {Hobbs, Robert F. and McNutt, Todd and Baechler, Sebastien and He Bin and Esaias, Caroline E. and Frey, Eric C. and Loeb, David M. and Wahl, Richard L. and Shokek, Ori and Sgouros, George, E-mail: gsgouro1@jhmi.edu},
abstractNote = {Purpose: Effective cancer treatment generally requires combination therapy. The combination of external beam therapy (XRT) with radiopharmaceutical therapy (RPT) requires accurate three-dimensional dose calculations to avoid toxicity and evaluate efficacy. We have developed and tested a treatment planning method, using the patient-specific three-dimensional dosimetry package 3D-RD, for sequentially combined RPT/XRT therapy designed to limit toxicity to organs at risk. Methods and Materials: The biologic effective dose (BED) was used to translate voxelized RPT absorbed dose (D{sub RPT}) values into a normalized total dose (or equivalent 2-Gy-fraction XRT absorbed dose), NTD{sub RPT} map. The BED was calculated numerically using an algorithmic approach, which enabled a more accurate calculation of BED and NTD{sub RPT}. A treatment plan from the combined Samarium-153 and external beam was designed that would deliver a tumoricidal dose while delivering no more than 50 Gy of NTD{sub sum} to the spinal cord of a patient with a paraspinal tumor. Results: The average voxel NTD{sub RPT} to tumor from RPT was 22.6 Gy (range, 1-85 Gy); the maximum spinal cord voxel NTD{sub RPT} from RPT was 6.8 Gy. The combined therapy NTD{sub sum} to tumor was 71.5 Gy (range, 40-135 Gy) for a maximum voxel spinal cord NTD{sub sum} equal to the maximum tolerated dose of 50 Gy. Conclusions: A method that enables real-time treatment planning of combined RPT-XRT has been developed. By implementing a more generalized conversion between the dose values from the two modalities and an activity-based treatment of partial volume effects, the reliability of combination therapy treatment planning has been expanded.},
doi = {10.1016/j.ijrobp.2010.08.022},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 80,
place = {United States},
year = {2011},
month = {7}
}