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Fractionation protocol design for treatment planningoptimization in SIRT using the OEDIPE software

Published online by Cambridge University Press:  30 September 2014

A. Petitguillaume ,
M. Bernardini ,
D. Broggio ,
C. de Labriolle Vaylet ,
D. Franck  and
A. Desbrée
A. Petitguillaume
Affiliation:
IRSN, Laboratoire d’Evaluation de la Dose Interne, 92262 Fontenay-aux-Roses, France.
M. Bernardini
Affiliation:
Hôpital Européen Georges Pompidou, Service de médecine nucléaire, 75015 Paris, France.
D. Broggio
Affiliation:
IRSN, Laboratoire d’Evaluation de la Dose Interne, 92262 Fontenay-aux-Roses, France.
C. de Labriolle Vaylet
Affiliation:
UPMC, Univ. Paris 06 Bio physics, 75005 Paris, France. Hôpital Trousseau, Service de médecine nucléaire, 75012 Paris, France.
D. Franck
Affiliation:
IRSN, Laboratoire d’Evaluation de la Dose Interne, 92262 Fontenay-aux-Roses, France.
A. Desbrée*
Affiliation:
IRSN, Laboratoire d’Evaluation de la Dose Interne, 92262 Fontenay-aux-Roses, France.
*
*aurelie.desbree@irsn.fr
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Abstract

To go further in the optimization of treatment planning in selective internal radiationtherapy (SIRT), radiobiological aspects can be accounted for with the OEDIPE software andused to design fractionation protocols. Dosimetry was performed using data from99mTc-MAAevaluations of 10 patients treated for hepatic metastases with SIRT. The maximalinjectable activity (MIA) was calculated, using a tolerance criterion onBEDmean,healthyliver equal to 54 Gy2.5, for different fractionationprotocols, varying the number of fractions, the repartition of activity and the time delaybetween fractions. OEDIPE was also used to calculate BEDmean and the EUD to the tumoralliver (TL) that would be delivered with those MIAs. Compared with a single-injectionprotocol, the MIA is increased on average by 23% ± 3%, 36% ± 5% and 45% ± 7% for fractionation protocols with 2, 3and 4 equal fractions, respectively, while BEDmean,TL is increased by 15% ± 2%, 23% ± 4% and 29% ± 5%. EUDTL, calculated for oneevaluation, is increased by 51%, 115% and 159% using 2, 3 and 4 equal fractions,respectively. For this evaluation, the optimal activity repartition for two-fractionprotocols is (3/4 − 1/4) fortime delays of less than 4 days, (2/3 − 1/3) for time delays between 4 and 6 days and (1/2 − 1/2) for time delays superior to 6 days.Finally, this study confirmed that OEDIPE can be regarded as a tool for treatment planningoptimization and fractionation protocol design in SIRT.

Keywords

OEDIPESIRTdosimetryfractionationtreatment planning
Type
Article
Information
Radioprotection , Volume 49 , Issue 4 , October 2014 , pp. 283 - 288
Copyright
© EDP Sciences, 2014

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References

Bernardini M., Smadja C., Faraggi M., Orio S., Petitguillaume A., Desbrée A., Ghazzar N. (2014) Selective liver internal radiation therapy with 90Y resin microspheres: comparison between pre-treatment activity calculation methods, Eur. J. Med. Phys. In press.
CEU – Council of the European Union (2013) Council directive 2013/59/EURATOM laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom, 5 December 2013, p. 25.
Cremonesi, M., Ferrari, M., Bartolomei, M., Orsi, F., Bonomo, G., Arico, D., Mallia, A., De Cicco, C., Pedroli, G., Paganelli, G. (2008) Radioembolisation with 90Y-microspheres: dosimetric and radiobiological investigation for multi-cycle treatment, Eur. J. Nucl. Med. Mol. Imaging 35, 2088-2096. Google ScholarPubMed
Dale, R.G. (1985) The application of the linear-quadratic dose-effect equation to fractionated and protracted radiotherapy, Br. J. Radiol. 58, 515-528. Google ScholarPubMed
Dale, R.G. (1989) Radiobiological assessment of permanent implants using tumour repopulation factors in the linear-quadratic model, Br. J. Radiol. 62, 241-244. Google ScholarPubMed
Dezarn, W.A., Cessna, J.T., DeWerd, L.A., Feng, W., Gates, V.L., Halama, J., Kennedy, A.S., Nag, S., Sarfaraz, M., Sehgal, V., Selwyn, R., Stabin, M.G., Thomadsen, B.R., Williams, L.E., Salem, R. (2011) Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies, Med. Phys. 38, 4824-4845. Google Scholar
Gulec, S.A., Mesoloras, G., Stabin, M. (2006) Dosimetric techniques in 90Y-microsphere therapy of liver cancer: the MIRD equations for dose calculations, J. Nucl. Med. 47, 1209-1211. Google ScholarPubMed
Ho, S., Lau, W.Y., Leung, T.W., Chan, M., Ngar, Y.K., Johnson, P.J., Li, A.K. (1996) Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours, Eur. J. Nucl. Med. 23, 947-952. Google ScholarPubMed
O’Donoghue, J.A. (1999) Implications of nonuniform tumor doses for radioimmunotherapy, J. Nucl. Med. 40, 1337-1341. Google ScholarPubMed
Petitguillaume, A., Bernardini, M., Hadid, L., de Labriolle-Vaylet, C., Franck, D., Desbrée, A. (2014a) Three-dimensional personalized Monte Carlo dosimetry in 90Y-microspheres therapy of hepatic metastases: non tumoral liver and lungs radiation protection considerations and treatment optimization, J. Nucl. Med. 55, 405-413. Google Scholar
Petitguillaume, A., Bernardini M., Broggio D., de Labriolle-Vaylet C., Franck D., Desbrée A. (2014b) OEDIPE, a software for personalized Monte Carlo dosimetry and treatment planning optimization in nuclear medicine: absorbed dose and biologically effective dose considerations, Radioprotection, 49(4)), 275-281.
RCR – The Royal College of Radiologists (2006) Fractionation in radiotherapy: A brief history. In: Radiotherapy dose-fractionation (Board of Faculty of Clinical Oncology, book auth.), pp. 10-13.