title: Radiobiological modeling analysis of the optimal fraction scheme in patients with peripheral non-small cell lung cancer undergoing stereotactic body radiotherapy.
abstract: This study aimed to determine the optimal fraction scheme (FS) in patients with small peripheral non-small cell lung cancer (NSCLC) undergoing stereotactic body radiotherapy (SBRT) with the 4 × 12 Gy scheme as the reference. CT simulation data for sixteen patients diagnosed with primary NSCLC or metastatic tumor with a single peripheral lesion ≤3 cm were used in this study. Volumetric modulated arc therapy (VMAT) plans were designed based on ten different FS of 1 × 25 Gy, 1 × 30 Gy, 1 × 34 Gy, 3 × 15 Gy, 3 × 18 Gy, 3 × 20 Gy, 4 × 12 Gy, 5 × 12 Gy, 6 × 10 Gy and 10 × 7 Gy. Five different radiobiological models were employed to predict the tumor control probability (TCP) value. Three other models were utilized to estimate the normal tissue complication probability (NTCP) value to the lung and the modified equivalent uniform dose (mEUD) value to the chest wall (CW). The 1 × 30 Gy regimen is recommended to achieve 4.2% higher TCP and slightly higher NTCP and mEUD values to the lung and CW compared with the 4 × 12 Gy schedule, respectively. This regimen also greatly shortens the treatment duration. However, the 3 × 15 Gy schedule is suggested in patients where the lung-to-tumor volume ratio is small or where the tumor is adjacent to the CW.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515031, China.
authors.forename: Bao-Tian
authors.initials: BT
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515031, China.
authors.forename: Jia-Yang
authors.initials: JY
authors.lastname: Lu
authors.affiliation: Department of Nosocomial Infection Management, The Second Affiliated Hospital of Shantou University Medical College, 69 North Dongsha Road, Shantou 515041, China.
authors.forename: Pei-Xian
authors.initials: PX
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515031, China.
authors.forename: Jian-Zhou
authors.initials: JZ
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515031, China.
authors.forename: De-Rui
authors.initials: DR
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515031, China.
authors.forename: Chuang-Zhen
authors.initials: CZ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden