Temporally Corrected Dose Accumulation -- Next Steps in the Biology of Reirradiation

ABSTRACT In modern radiotherapy, multiple courses of radiation are becoming increasingly common as a treatment regimen to extend progression-free and overall survival in patients with oligometastatic disease. However, normal tissue recovery over time has not been well characterized, and there are few models for clinicians to use when evaluating potential toxicities in subsequent radiation treatments. The lack of standardization when documenting a patient’s radiotherapy history presents a major barrier to conducting large scale studies. To advance our understanding of normal tissue recovery post-radiation, we propose the addition of a new object accompanied by a suite of mathematical models linked to toxicity information in a patient’s medical record. This object leverages the Digital Imaging and Communications in Medicine (DICOM) standard to serve as a centralized data store for radiotherapy planning and treatment, thereby facilitating a better analysis of therapeutic outcomes and tissue response over the course of radiotherapy.