Key result
Pencil Beam underestimates tumor control and pneumonitis risk versus Collapsed Cone and Monte Carlo algorithms.
Why the study?
The effects of different Dose Calculation Algorithms and Biologically Model-Related Parameters on predicting cardiopulmonary complications after left breast radiotherapy were unclear.
How do different Dose Calculation Algorithms and Biologically Model-Related Parameters affect the prediction of cardiopulmonary complications in left breast radiation therapy?
Observational (n=21)
No
How do different Dose Calculation Algorithms and Biologically Model-Related Parameters affect the prediction of cardiopulmonary complications in left breast radiation therapy?
Dose calculation algorithms strongly influence tumor control probability estimates, whereas biologically model-related parameters are more effective in estimating normal tissue complication probabilities like cardiopulmonary toxicity.
Answers are grounded in this paper and cite their sources.
Caution advised with Pencil Beam for TCP/NTCP estimates in left breast RT; leaves open prospective validation of algorithm-specific biological modeling.
Background: Breast cancer requires evaluating treatment plans using dosimetric and biological parameters. Considering radiation dose distribution and tissue response, healthcare professionals can optimize treatment plans for better outcomes. Objective: This study aimed to evaluate the effects of the different Dose Calculation Algorithms (DCAs) and Biologically Model-Related Parameters (BMRPs) on the prediction of cardiopulmonary complications due to left breast radiotherapy. Material and Methods: In this practical study, the treatment plans of 21 female patients were simulated in the Monaco Treatment Planning System (TPS) with a prescribed dose of 50 Gy in 25 fractions. Dose distribution was extracted using the three DCAs [Pencil Beam (PB), Collapsed Cone (CC), and Monte Carlo (MC)]. Cardiopulmonary complications were predicted by Normal Tissue Complication Probability (NTCP) calculations using different dosimetric and biological parameters. The Lyman-Kutcher-Burman (LKB) and Relative-Seriality (RS) models were used to calculate NTCP. The endpoint for NTCP calculation was pneumonitis, pericarditis, and late cardiac mortality. The ANOVA test was used for statistical analysis. Results: In calculating Tumor Control Probability (TCP), a statistically significant difference was observed between the results of DCAs in the Poisson model. The PB algorithm estimated NTCP as less than others for all Pneumonia BMRPs. Conclusion: The impact of DCAs and BMRPs differs in the estimation of TCP and NTCP. DCAs have a stronger influence on TCP calculation, providing more effective results. On the other hand, BMRPs are more effective in estimating NTCP. Consequently, parameters for radiobiological indices should be cautiously used s to ensure the appropriate consideration of both DCAs and BMRPs.
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Kargar et al. (2024) conducted an observational in Left breast cancer (n=21). Dose Calculation Algorithms (Pencil Beam, Collapsed Cone, Monte Carlo) vs. Comparison among algorithms was evaluated on Tumor Control Probability (TCP) using the Poisson model (p=0.005). The Pencil Beam dose calculation algorithm significantly underestimated Tumor Control Probability and Normal Tissue Complication Probability for pneumonitis compared to Collapsed Cone and Monte Carlo algorithms in left breast radiotherapy.
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