title: Dose-volume effects in rat thoracolumbar spinal cord: an evaluation of NTCP models.
abstract: OBJECTIVE
  To evaluate models for normal-tissue-complication probability (NTCP) on describing the dose-volume effect in rat thoracolumbar spinal cord.
  
  
  METHODS
  Single-dose irradiation of four field lengths (4, 1.5, 1.0, and 0.5 cm) was evaluated by the endpoints paresis and white-matter necrosis. The resulting dose-response data were used to rank phenomenological and tissue architecture NTCP models.
  
  
  RESULTS
  The 0.5-cm field length showed a steep increase in radiation tolerance. Statistical analysis of the model fits, which included evaluation of goodness of fit (GOF) and confidence intervals, resulted in the rejection of all the models considered. Excluding the smallest field length, the Schultheiss (D(50) = 21.5 Gy, k = 26.5), the relative seriality (D(50) = 21.4 Gy, s = 1.6, gamma(50) = 6.3), and the critical element (D(50,FSU) = 26.6 Gy, gamma(50,FSU) = 2.3, n = 1.3) model gave the best fit.
  
  
  CONCLUSIONS
  A thorough statistical analysis resulted in a serial or critical-element behavior for the field lengths of 1.0 cm and greater. Including the 0.5-cm field length, the radiation response markedly diverged from serial properties, but none of the models applied acceptably described this dose-response relationship. This study suggests that the commonly assumed serial behavior of the spinal cord might be valid for daily use in external- beam irradiation.
authors.affiliation: Department of Radiation Oncology, University Medical Center, Nijmegen, The Netherlands. m.philippens@rther.umcn.nl
authors.forename: Marielle E P
authors.initials: ME
authors.lastname: Philippens
authors.forename: Lucas A M
authors.initials: LA
authors.lastname: Pop
authors.forename: Andries G
authors.initials: AG
authors.lastname: Visser
authors.forename: Suzanne A M W
authors.initials: SA
authors.lastname: Schellekens
authors.forename: Albert J
authors.initials: AJ
authors.lastname: van der Kogel
mesh_terms: D000818:Animals; D016001:Confidence Intervals; D004307:Dose-Response Relationship, Radiation; D008159:Lumbar Vertebrae; D008297:Male; D011833:Radiation Injuries, Experimental / Q000473:pathology*; D011836:Radiation Tolerance; D051381:Rats; D017208:Rats, Wistar; D013116:Spinal Cord / Q000528:radiation effects*; D013904:Thoracic Vertebrae