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Survival and tumour control probability in tumours with heterogeneous oxygenations: A comparison between the linear-quadratic and the universal survival curve models for high doses
Stockholm University.
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
Karolinska University Hospital.
Stockholm University and Karolinska Institutet.ORCID iD: 0000-0002-7101-240X
2014 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 53, no 8, 1035-1040 p.Article in journal (Refereed) Published
Abstract [en]

Background: The validity of the linear-quadratic (LQ) model at high doses has been questioned due to a decreasing agreement between predicted survival and experimental cell survival data. A frequently proposed alternative is the universal survival curve (USC) model, thought to provide a better fit in the high-dose region. The comparison between the predictions of the models has mostly been performed for uniform populations of cells with respect to sensitivity to radiation. This study aimed to compare the two models in terms of cell survival and tumour control probability (TCP) for cell populations with mixed sensitivities related to their oxygenation.

Methods: The study was performed in two parts. For the first part, cell survival curves were calculated with both models assuming various homogeneous populations of cells irradiated with uniform doses. For the second part, a realistic 3D-model of complex tumour oxygenation was used to study the impact of the differences in cell survival on the modelled tumour control probability. Cellular response was assessed with the LQ and USC models at voxel level and a Poisson TCP model at tumour level.

Results: For hypoxic tumours, the disputed continuous bend of the LQ survival curve was counteracted by the increased radio-resistance of the hypoxic cells and the survival curves started to diverge only at much higher doses than for oxic tumours. This was also reflected by the TCP curves for hypoxic tumours for which the difference in D50 values for the LQ and USC models was reduced from 5.4 to 0.2 Gy for 1 and 3 fractions respectively in a tumour with only 1.1% hypoxia and from 9.5 to 0.4 Gy in a tumour with 11.1% hypoxia.

Conclusions: For a large range of fractional doses including hypofractionated schemes, the difference in predicted survival and tumour control probability between the LQ and USC models for tumours with heterogeneous oxygenation was found to be negligible.

Place, publisher, year, edition, pages
Informa Healthcare, 2014. Vol. 53, no 8, 1035-1040 p.
National Category
Cancer and Oncology Radiology, Nuclear Medicine and Medical Imaging
URN: urn:nbn:se:liu:diva-106635DOI: 10.3109/0284186X.2014.925582ISI: 000340892900007PubMedID: 24957551OAI: diva2:717607
Available from: 2014-05-16 Created: 2014-05-16 Last updated: 2015-08-11

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Dasu, AlexandruToma-Dasu, Iuliana
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Division of Radiological SciencesFaculty of Health SciencesDepartment of Radiation Physics
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Cancer and OncologyRadiology, Nuclear Medicine and Medical Imaging

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