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Radiation Oncology
Published in: Radiation Oncology 1/2016

Open Access 01-12-2016 | Research

Biological modelling of the radiation dose escalation effect of regional hyperthermia in cervical cancer

Authors: J. Crezee, C. M. van Leeuwen, A. L. Oei, L. E. van Heerden, A. Bel, L. J. A. Stalpers, P. Ghadjar, N. A. P. Franken, H. P. Kok

Published in: Radiation Oncology | Issue 1/2016

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Abstract

Background

Locoregional hyperthermia combined with radiotherapy significantly improves locoregional control and overall survival for cervical tumors compared to radiotherapy alone. In this study biological modelling is applied to quantify the effect of radiosensitization for three cervical cancer patients to evaluate the improvement in equivalent dose for the combination treatment with radiotherapy and hyperthermia.

Methods

The Linear-Quadratic (LQ) model extended with temperature-dependent LQ-parameters α and β was used to model radiosensitization by hyperthermia and to calculate the conventional radiation dose that is equivalent in biological effect to the combined radiotherapy and hyperthermia treatment. External beam radiotherapy planning was performed based on a prescription dose of 46Gy in 23 fractions of 2Gy. Hyperthermia treatment using the AMC-4 system was simulated based on the actual optimized system settings used during treatment.

Results

The simulated hyperthermia treatments for the 3 patients yielded a T50 of 40.1 °C, 40.5 °C, 41.1 °C and a T90 of 39.2 °C, 39.7 °C, 40.4 °C, respectively. The combined radiotherapy and hyperthermia treatment resulted in a D95 of 52.5Gy, 55.5Gy, 56.9Gy in the GTV, a dose escalation of 7.3–11.9Gy compared to radiotherapy alone (D95 = 45.0–45.5Gy).

Conclusions

This study applied biological modelling to evaluate radiosensitization by hyperthermia as a radiation-dose escalation for cervical cancer patients. This model is very useful to compare the effectiveness of different treatment schedules for combined radiotherapy and hyperthermia treatments and to guide the design of clinical studies on dose escalation using hyperthermia in a multi-modality setting.
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Metadata
Title
Biological modelling of the radiation dose escalation effect of regional hyperthermia in cervical cancer
Authors
J. Crezee
C. M. van Leeuwen
A. L. Oei
L. E. van Heerden
A. Bel
L. J. A. Stalpers
P. Ghadjar
N. A. P. Franken
H. P. Kok
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2016
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-016-0592-z

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