Radiobiologically based assessments of the net costs of fractionated focal radiotherapy

被引:9
作者
Jones, B [1 ]
Dale, RG
机构
[1] Clatterbridge Ctr Oncol, Wirral L63 4JY, Merseyside, England
[2] Charing Cross Hosp, Dept Radiat Phys & Radiobiol, London W6 8RF, England
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1998年 / 41卷 / 05期
关键词
radiobiology; focal radiotherapy; fractionation; linear quadratic model; health economics;
D O I
10.1016/S0360-3016(98)00155-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To assess the potential changes in the net costs of focal radiotherapy techniques at differing doses per fraction and interfraction intervals. Methods: Linear quadratic radiobiological modeling is used with appropriate variations in the radiosensitivity and tumor cell proliferation parameters, The notional cost of treatment is calculated from the number of fractions, cost per fraction and the cost of treatment failure, which is itself related to (1-TCP) where TCP is the tumor cure probability. Additional Monte Carlo calculations from ranges of radiobiological parameters have been used to simulate the cost of treatment of tumor populations. Results: The optimum dose per fraction (and optimum overall cost) for conventional (nonfocal) radiotherapy is generally at low doses of around 2 Gy per fraction, The use of hyperfractionated and accelerated radiotherapy in addition to focal radiotherapy techniques appear to be indicated for more radioresistant tumors and if tumor proliferation is extremely rapid, but the need for treatment acceleration is much reduced where effective focal techniques are used. Conclusions: Radiobiological and economic modeling can be used to guide clinical choices of dose Fractionation techniques providing the key radiobiological parameters are known or if the ranges of likely parameters in a tumor population are known. Focal radiotherapy, by the introduction of changes in the physical dose distribution, produces an upward shift in the optimum dose per fraction and a reduced dependency on overall treatment time. (C) 1998 Elsevier Science Inc.
引用
收藏
页码:1139 / 1148
页数:10
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