ArticleJCO clinical cancer informatics
Influence of Fractionation and Beam Sequencing on Absorbed Dose to Circulating Lymphocytes During Ultra-High Dose Rate and Conventional Radiotherapy: An In Silico Study.
Article in JCO clinical cancer informatics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSeveral in silico models concluded that ultra-high dose rate (UHDR) radiotherapy could spare large quantities of circulating lymphocytes. However, preclinical studies failed to show a reduction in radiation-induced lymphopenia after UHDR irradiation compared with conventional dose rates (CONV). This study aims to investigate the influence of fractionation and beam sequencing on absorbed dose to circulating lymphocytes during CONV and UHDR irradiations. MATERIALS AND
methodsThe LymphoDose framework was applied to a cohort of 162 patients treated for brain tumors with 3D conformal radiotherapy. Four scenarios of UHDR treatment were compared: (S1) one fraction with all beams delivered simultaneously, (S2) one fraction with sequentially delivered beams, (S3) three fractions with all beams delivered simultaneously, and (S4) three fractions with sequentially delivered beams.
resultsUHDR fractionation and the beam delivery scheme had a significant impact on irradiated blood volume (1.3% ± 0.1% for S1
conclusionThe doses delivered to lymphoid organs account for a substantial portion of the total dose received by the lymphocyte pool, showing only a limited difference between UHDR and CONV in terms of lymphocyte exposure. The fractionation strategy of UHDR irradiation beams could play an important role in successfully translating UHDR treatments into clinical practice.
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