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The dose response relation for rat spinal cord paralysis analyzed in terms of the effective size of the functional subunit
Stockholm University, Faculty of Science, Medical Radiation Physics (together with KI).
Manuscript (Other academic)
Identifiers
URN: urn:nbn:se:su:diva-24756OAI: oai:DiVA.org:su-24756DiVA: diva2:198261
Note
Part of urn:nbn:se:su:diva-7433Available from: 2008-03-13 Created: 2008-03-13 Last updated: 2010-01-13Bibliographically approved
In thesis
1. Improved dose response modeling for normal tissue damage and therapy optimization
Open this publication in new window or tab >>Improved dose response modeling for normal tissue damage and therapy optimization
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present thesis is focused on the development and application of dose response models for radiation therapy. Radiobiological models of tissue response to radiation are an integral part of the radiotherapeutic process and a powerful tool to optimize tumor control and minimize damage to healthy tissues for use in clinical trials. Ideally, the models could work as a historical control arm of a clinical trial eliminating the need to randomize patents to suboptimal therapies. In the thesis overview part, some of the basic properties of the dose response relation are reviewed and the most common radiobiological dose-response models are compared with regard to their ability to describe experimental dose response data for rat spinal cord using the maximum likelihood method. For vascular damage the relative seriality model was clearly superior to the other models, whereas for white matter necrosis all models were quite good except possibly the inverse tumor and critical element models. The radiation sensitivity, seriality and steepness of the dose-response relation of the spinal cord is found to vary considerably along its length. The cervical region is more radiation sensitive, more parallel, expressing much steeper dose-response relation and more volume dependent probability of inducing radiation myelitis than the thoracic part. The higher number of functional subunits (FSUs) consistent with a higher amount of white matter close to the brain may be responsible for these phenomena. With strongly heterogeneous dose delivery and due to the random location of FSUs, the effective size of the FSU and the mean dose deposited in it are of key importance and the radiation sensitivity distribution of the FSU may be an even better descriptor for the response of the organ. An individual optimization of a radiation treatment has the potential to increase the therapeutic window and improve cure for a subgroup of patients.

Place, publisher, year, edition, pages
Stockholm: Medicinsk strålningsfysik (tills m KI), 2008. 52 p.
Keyword
Normal tissue complications, radiobiological models, dose-response, volume effect, spinal cord, effective FSU size
Research subject
Medical Radiation Physics
Identifiers
urn:nbn:se:su:diva-7433 (URN)978-91-7155-584-7 (ISBN)
Public defence
2008-04-04, Rolf Lufts Auditorium, Karolinska Universitetssjukhuset, Solna, 09:15
Opponent
Supervisors
Available from: 2008-03-13 Created: 2008-03-13Bibliographically approved

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