open access

Vol 22, No 4 (2017)
Original research articles
Published online: 2017-07-01
Submitted: 2016-06-24
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Validation of the liver mean dose in terms of the biological effective dose for the prevention of radiation-induced liver damage

Hiroshi Doi, Norihisa Masai, Kenji Uemoto, Osamu Suzuki, Hiroya Shiomi, Daisaku Tatsumi, Ryoong-Jin Oh
DOI: 10.1016/j.rpor.2017.02.011
·
Rep Pract Oncol Radiother 2017;22(4):303-309.

open access

Vol 22, No 4 (2017)
Original research articles
Published online: 2017-07-01
Submitted: 2016-06-24

Abstract

Aim

The purpose of this study was to determine the optimal mean liver biologically effective dose (BED) to prevent radiation-induced liver disease (RILD) in stereotactic body radiation therapy (SBRT).

Background

The actual mean doses appropriate for liver irradiation in modern radiotherapy techniques have not been adequately investigated, although SBRT is sometimes alternatively performed using fractionated regimens.

Materials and methods

SBRT treatment plans for liver tumors in 50 patients were analyzed. All distributions of the physical doses were transformed to BED2 using the linear-quadratic model. The relationship between physical doses and the BED2 for the liver were then analyzed, as was the relationship between the mean BED2 for the liver and the planning target volume (PTV).

Results

A significantly positive correlation was observed between the mean physical dose for the background liver and the mean BED2 for the whole liver (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.0001, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.9558). Using the LQ model, a mean BED2 of 73 and 16[[ce:hsp sp="0.25"/]]Gy for the whole liver corresponded to the hepatic tolerable mean physical dose of 21 and 6[[ce:hsp sp="0.25"/]]Gy for Child–Pugh A- and B-classified patients, respectively. Additionally, the PTV values were positively correlated with the BEDs for the whole liver (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.0001, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.8600), and the background liver (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.0001, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.7854).

Conclusion

A mean BED2 of 73 and 16[[ce:hsp sp="0.25"/]]Gy for the whole liver appeared appropriate to prevent RILD in patients with Child–Pugh classes A and B, respectively. The mean BED2 for the liver correlated well with the PTV.

Abstract

Aim

The purpose of this study was to determine the optimal mean liver biologically effective dose (BED) to prevent radiation-induced liver disease (RILD) in stereotactic body radiation therapy (SBRT).

Background

The actual mean doses appropriate for liver irradiation in modern radiotherapy techniques have not been adequately investigated, although SBRT is sometimes alternatively performed using fractionated regimens.

Materials and methods

SBRT treatment plans for liver tumors in 50 patients were analyzed. All distributions of the physical doses were transformed to BED2 using the linear-quadratic model. The relationship between physical doses and the BED2 for the liver were then analyzed, as was the relationship between the mean BED2 for the liver and the planning target volume (PTV).

Results

A significantly positive correlation was observed between the mean physical dose for the background liver and the mean BED2 for the whole liver (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.0001, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.9558). Using the LQ model, a mean BED2 of 73 and 16[[ce:hsp sp="0.25"/]]Gy for the whole liver corresponded to the hepatic tolerable mean physical dose of 21 and 6[[ce:hsp sp="0.25"/]]Gy for Child–Pugh A- and B-classified patients, respectively. Additionally, the PTV values were positively correlated with the BEDs for the whole liver (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.0001, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.8600), and the background liver (P[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.0001, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.7854).

Conclusion

A mean BED2 of 73 and 16[[ce:hsp sp="0.25"/]]Gy for the whole liver appeared appropriate to prevent RILD in patients with Child–Pugh classes A and B, respectively. The mean BED2 for the liver correlated well with the PTV.

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Keywords

Biologically effective dose; Child–Pugh classification; Intensity modulated radiation therapy; Stereotactic body radiation therapy; Radiation-induced liver disease; Hepatocellular carcinoma

About this article
Title

Validation of the liver mean dose in terms of the biological effective dose for the prevention of radiation-induced liver damage

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 22, No 4 (2017)

Pages

303-309

Published online

2017-07-01

DOI

10.1016/j.rpor.2017.02.011

Bibliographic record

Rep Pract Oncol Radiother 2017;22(4):303-309.

Keywords

Biologically effective dose
Child–Pugh classification
Intensity modulated radiation therapy
Stereotactic body radiation therapy
Radiation-induced liver disease
Hepatocellular carcinoma

Authors

Hiroshi Doi
Norihisa Masai
Kenji Uemoto
Osamu Suzuki
Hiroya Shiomi
Daisaku Tatsumi
Ryoong-Jin Oh

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