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The influence of normal tissue and tumour response uncertainties on the treatment outcome of biologically optimized breast cancer radiation therapy
Stockholm University, Faculty of Science, Medical Radiation Physics (together with KI).
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Manuscript (Other academic)
URN: urn:nbn:se:su:diva-23501OAI: diva2:192351
Part of urn:nbn:se:su:diva-313Available from: 2004-12-01 Created: 2004-12-01 Last updated: 2010-01-13Bibliographically approved
In thesis
1. Biological optimization of angle of incidence and intensity modulation in breast and cervix cancer radiation therapy
Open this publication in new window or tab >>Biological optimization of angle of incidence and intensity modulation in breast and cervix cancer radiation therapy
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Biological treatment optimization aim at improving radiation therapy by accounting for the radiobiological tumour and normal tissues response properties when optimizing the dose delivery. Generally traditional methods, using only dosimetrical measures, disregard the nonlinear radiation response of different tumours and normal tissues. The accumulated knowledge on tissue response to radiation, in the form of more accurate dose response relations, cell survival models and their associated biological parameters, alongside with the tools for biological treatment plan optimization, has allowed the present investigation on the potential merits of biologically based treatment optimization in radiation therapy.

With a more widespread implementation of intensity modulated radiation therapy in the clinic, there is an increasing demand for faster and safer treatment delivery techniques. In this thesis biological treatment plan optimization, using the probability to achieve complication free tumour control as the quantifier for treatment outcome, was applied to radiation therapy of early breast cancer and advanced cervix cancer. It is shown that very conformal dose distributions can generally be produced with 3 or 4 optimally orientated coplanar intensity modulated beams, without having clinically significant losses in treatment outcome from the optimal dose distribution.

By using exhaustive search methods, the optimal coplanar beam directions for intensity modulated photon beams for early breast cancer and the optimal non-coplanar directions for an advanced cervix cancer were investigated. Although time consuming, exhaustive search methods have the advantage of revealing most features involving interactions between a small number of beams and how this may influence the treatment outcome. Thus phase spaces may serve as a general database for selecting an almost optimal treatment configuration for similar patients. Previous knowledge acquired with physically optimized uniform beam radiation therapy may not apply when intensity modulated biological optimization is used. Thus unconventional treatment directions were sometimes found.

Place, publisher, year, edition, pages
Stockholm: Medicinsk strålningsfysik (tills m KI), 2004. 58 p.
biological treatment planning, angle of incidence optimization, intensity modulation, breast and cervix cancer
National Category
Radiology, Nuclear Medicine and Medical Imaging
urn:nbn:se:su:diva-313 (URN)91-7265-980-7 (ISBN)
Public defence
2004-12-22, föreläsningssalen, Cancer Centrum Karolinska, R8:00, Karolinska universitetssjukhuset, Stockholm, 09:15
Available from: 2004-12-01 Created: 2004-12-01Bibliographically approved

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