title: Equivalent uniform dose concept evaluated by theoretical dose volume histograms for thoracic irradiation.
abstract: OBJECTIVE
  The goal of our study was to quantify the limits of the EUD models for use in score functions in inverse planning software, and for clinical application.
  
  
  METHODS
  We focused on oesophagus cancer irradiation. Our evaluation was based on theoretical dose volume histograms (DVH), and we analyzed them using volumetric and linear quadratic EUD models, average and maximum dose concepts, the linear quadratic model and the differential area between each DVH.
  
  
  RESULTS
  We evaluated our models using theoretical and more complex DVHs for the above regions of interest. We studied three types of DVH for the target volume: the first followed the ICRU dose homogeneity recommendations; the second was built out of the first requirements and the same average dose was built in for all cases; the third was truncated by a small dose hole. We also built theoretical DVHs for the organs at risk, in order to evaluate the limits of, and the ways to use both EUD(1) and EUD/LQ models, comparing them to the traditional ways of scoring a treatment plan. For each volume of interest we built theoretical treatment plans with differences in the fractionation.
  
  
  CONCLUSIONS
  We concluded that both volumetric and linear quadratic EUDs should be used. Volumetric EUD(1) takes into account neither hot-cold spot compensation nor the differences in fractionation, but it is more sensitive to the increase of the irradiated volume. With linear quadratic EUD/LQ, a volumetric analysis of fractionation variation effort can be performed.
authors.affiliation: Department of Radiotherapy, Besançon University Hospital, Boulevard Fleming, F-25030 Besançon Cedex, France. jldumas@chu-besancon.fr
authors.forename: J L
authors.initials: JL
authors.lastname: Dumas
authors.forename: F
authors.initials: F
authors.lastname: Lorchel
authors.forename: Y
authors.initials: Y
authors.lastname: Perrot
authors.forename: P
authors.initials: P
authors.lastname: Aletti
authors.forename: A
authors.initials: A
authors.lastname: Noel
authors.forename: D
authors.initials: D
authors.lastname: Wolf
authors.forename: P
authors.initials: P
authors.lastname: Courvoisier
authors.forename: J F
authors.initials: JF
authors.lastname: Bosset
mesh_terms: D001822:Body Burden; D003198:Computer Simulation; D004938:Esophageal Neoplasms / Q000503:physiopathology* / Q000532:radiotherapy*; D006801:Humans; D008954:Models, Biological; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods*; D012062:Relative Biological Effectiveness; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000532:radiotherapy