Maximum likelihood estimation of dose-response parameters for therapeutic operating characteristic (TOC) analysis of carcinoma of the nasopharynx.
A Therapeutic Operating Characteristic (TOC) curve for radiation therapy plots, for all possible treatment doses, the probability of tumor ablation as a function of the probability of radiation-induced complication. Application of this analysis to actual therapeutic situations requires that dose-response curves for ablation and for complication be estimated from clinical data. We describe an approach in which "maximum likelihood estimates" of these dose-response curves are made, and we apply this approach to data collected on responses to radiotherapy for carcinoma of the nasopharynx. TOC curves constructed from the estimated dose-response curves are subject to moderately large uncertainties because of the limitations of available data. These TOC curves suggest, however, that treatment doses greater than 1800 ret may substantially increase the probability of tumor ablation with little increase in the risk of radiation-induced cervical myelopathy, especially for T1 and T2 tumors.
D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008962:Models, Theoretical; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D012306:Risk; D013118:Spinal Cord Diseases / Q000209:etiology