线性二次模型在低分次放射治疗放射外科中的应用.pptVIP

射线能量对子宫内膜癌调强放疗计划质量的影响 杨瑞杰　姜伟娟　王俊杰 LQ模型在低分次放射治疗中的应用 杨瑞杰 王俊杰 北 京 大 学 第 三 医 院 LQ模型在低分次放射治疗中的应用 低分次放射治疗 低分次放射治疗 低分次放射治疗 背 景 背 景 低分次放射治疗剂量递增试验 8 Gy/fx x 3 = 24 Gy 10 Gy/fx x 3 = 30 Gy 12 Gy/fx x 3 = 36 Gy 14 Gy/fx x 3 = 42 Gy 16 Gy/fx x 3 = 48 Gy 18 Gy/fx x 3 = 54 Gy 20 Gy/fx x 3 = 60 Gy 基本形式简单 模型扩展可以考虑修复、再群体化等 机制模型，优于经验模型NSD, TDF 广泛用于常规分割方案的等效剂量计算 实验室数据支持（10-18 Gy） 低分次放射治疗组织生物学行为特性 　细胞凋亡 　肿瘤干细胞 乏氧、再氧和、再群体化、放射敏感性 　分子、细胞、组织水平的变化（血管损伤） 结　论 小 结 致　谢 飞利浦公司 北京大学第三医院放疗科医生 Acknowledgements Thanks AbstractID: 8201 Title: A linear-quadratic-linear formulation to model radiation doseresponse Purpose: Recent technological advances enable radiotherapy to be delivered in a highly conformal manner almost anywhere in the body. This has renewed interest in hypofractionation wherein the tumor is delivered a few fractions of large dose/fraction. Extrapolating clinical experience with conventional fractionations to fractions of high dose is important when designing hypofractionated regimens. Methods and Materials: The concept of biologically effective dose (BED) based on the linear-quadratic (LQ) formulation e-(D + D2) is useful for intercomparing conventional fractionations but is suspect at high dose because the LQ curve bends continuously on the log-linear plot. A linear-quadratic-linear (LQ-L) formulation which better fits the final exponential response of experimental dose-response studies at high dose is described. This new formulation requires only one new term, the dose DT at which the LQ curve transitions to a linear tail. LQ-L is applied to published dose-response curves and the clinical implications of LQ-L are examined across a wide range of fractionations. Results: For fractions of high dose, the LQ formulation underestimates the dose per fraction required to maintain equivalency with conventional regimens. The LQ-L model fits a wide variety of experimental survival data over a wide range of dose. When DT = 2/ Gy, the line tangent to the LQ curve at DT i