title: Thermoradiotherapy planning: Integration in routine clinical practice.
abstract: Planning of combined radiotherapy and hyperthermia treatments should be performed taking the synergistic action between the two modalities into account. This work evaluates the available experimental data on cytotoxicity of combined radiotherapy and hyperthermia treatment and the requirements for integration of hyperthermia and radiotherapy treatment planning into a single planning platform. The underlying synergistic mechanisms of hyperthermia include inhibiting DNA repair, selective killing of radioresistant hypoxic tumour tissue and increased radiosensitivity by enhanced tissue perfusion. Each of these mechanisms displays different dose-effect relations, different optimal time intervals and different optimal sequences between radiotherapy and hyperthermia. Radiosensitisation can be modelled using the linear-quadratic (LQ) model to account for DNA repair inhibition by hyperthermia. In a recent study, an LQ model-based thermoradiotherapy planning (TRTP) system was used to demonstrate that dose escalation by hyperthermia is equivalent to ∼10 Gy for prostate cancer patients treated with radiotherapy. The first step for more reliable TRTP is further expansion of the data set of LQ parameters for normally oxygenated normal and tumour tissue valid over the temperature range used clinically and for the relevant time intervals between radiotherapy and hyperthermia. The next step is to model the effect of hyperthermia in hypoxic tumour cells including the physiological response to hyperthermia and the resulting reoxygenation. Thermoradiotherapy planning is feasible and a necessity for an optimal clinical application of hyperthermia combined with radiotherapy in individual patients.
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.
authors.forename: Hans
authors.initials: H
authors.lastname: Crezee
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.
authors.forename: Caspar M
authors.initials: CM
authors.lastname: van Leeuwen
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.|b Laboratory for Experimental Oncology and Radiobiology , Academic Medical Centre , Amsterdam , The Netherlands.
authors.forename: Arlene L
authors.initials: AL
authors.lastname: Oei
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.
authors.forename: Lukas J A
authors.initials: LJ
authors.lastname: Stalpers
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.
authors.forename: Arjan
authors.initials: A
authors.lastname: Bel
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.|b Laboratory for Experimental Oncology and Radiobiology , Academic Medical Centre , Amsterdam , The Netherlands.
authors.forename: Nicolaas A
authors.initials: NA
authors.lastname: Franken
authors.affiliation: a Department of Radiation Oncology , Academic Medical Centre , Amsterdam and.
authors.forename: H Petra
authors.initials: HP
authors.lastname: Kok
mesh_terms: D000818:Animals; D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced; D008954:Models, Biological; D009369:Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D011836:Radiation Tolerance; D011879:Radiotherapy Dosage
keywords: Hyperthermia; TER; linear-quadratic model; radiotherapy; treatment planning