title: Normal tissue dose-effect models in biological dose optimisation.
abstract: Sophisticated radiotherapy techniques like intensity modulated radiotherapy with photons and protons rely on numerical dose optimisation. The evaluation of normal tissue dose distributions that deviate significantly from the common clinical routine and also the mathematical expression of desirable properties of a dose distribution is difficult. In essence, a dose evaluation model for normal tissues has to express the tissue specific volume effect. A formalism of local dose effect measures is presented, which can be applied to serial and parallel responding tissues as well as target volumes and physical dose penalties. These models allow a transparent description of the volume effect and an efficient control over the optimum dose distribution. They can be linked to normal tissue complication probability models and the equivalent uniform dose concept. In clinical applications, they provide a means to standardize normal tissue doses in the face of inevitable anatomical differences between patients and a vastly increased freedom to shape the dose, without being overly limiting like sets of dose-volume constraints.
authors.affiliation: Sektion für Biomedizinische Physik, Uniklinik für Radioonkologie Tübingen, Tübingen. markus.alber@med.uni-tuebingen.de
authors.forename: Markus
authors.initials: M
authors.lastname: Alber
mesh_terms: D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017785:Photons; D011522:Protons; D011829:Radiation Dosage; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D011879:Radiotherapy Dosage; D012007:Rectum / Q000000981:diagnostic imaging; D012016:Reference Values
chemical_list: D011522:Protons