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Clinical oxygen enhancement ratio of tumors in carbon ion radiotherapy: the influence of local oxygenation changes
Stockholm University, Sweden.
Stockholm University, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics.ORCID iD: 0000-0001-8171-2541
Aarhus University, Denmark.
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2014 (English)In: Journal of radiation research, ISSN 0449-3060, E-ISSN 1349-9157, Vol. 55, no 5, 902-911 p.Article in journal (Refereed) Published
Abstract [en]

The effect of carbon ion radiotherapy on hypoxic tumors has recently been questioned because of low linear energy transfer (LET) values in the spread-out Bragg peak (SOBP). The aim of this study was to investigate the role of hypoxia and local oxygenation changes (LOCs) in fractionated carbon ion radiotherapy. Three-dimensional tumors with hypoxic subvolumes were simulated assuming interfraction LOCs. Different fractionations were applied using a clinically relevant treatment plan with a known LET distribution. The surviving fraction was calculated, taking oxygen tension, dose and LET into account, using the repairable–conditionally repairable (RCR) damage model with parameters for human salivary gland tumor cells. The clinical oxygen enhancement ratio (OER) was defined as the ratio of doses required for a tumor control probability of 50% for hypoxic and well-oxygenated tumors. The resulting OER was well above unity for all fractionations. For the hypoxic tumor, the tumor control probability was considerably higher if LOCs were assumed, rather than static oxygenation. The beneficial effect of LOCs increased with the number of fractions. However, for very low fraction doses, the improvement related to LOCs did not compensate for the increase in total dose required  for tumor control. In conclusion, our results suggest that hypoxia can influence the outcome of carbon ion radiotherapy because of the non-negligible oxygen effect at the low LETs in the SOBP. However, if LOCs occur, a relatively high level of tumor control probability is achievable with a large range of fractionation schedules for tumors with hypoxic subvolumes, but both hyperfractionation and hypofractionation should be pursued with caution.

Place, publisher, year, edition, pages
Oxford University Press, 2014. Vol. 55, no 5, 902-911 p.
Keyword [en]
hypoxia, OER, TCP, RCR, carbon ion, fractionation, LOC
National Category
Cancer and Oncology
URN: urn:nbn:se:liu:diva-105890DOI: 10.1093/jrr/rru020ISI: 000342223100008PubMedID: 24728013OAI: diva2:711975
Available from: 2014-04-11 Created: 2014-04-11 Last updated: 2015-08-11

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Dasu, AlexandruFurusawa, YoshiyaToma-Dasu, Iuliana
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