Preliminary Calculation of RBE-weighted Dose Distribution for Cerebral Radionecrosis in Carbon-ion Treatment Planning

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  • KASE Yuki
    Research Center for Charged Particle Therapy, National Institute of Radiological Sciences
  • HIMUKAI Takeshi
    Research Center for Charged Particle Therapy, National Institute of Radiological Sciences
  • NAGANO Ai
    Research Center for Charged Particle Therapy, National Institute of Radiological Sciences
  • TAMESHIGE Yuji
    Proton Therapy Center, Fukui Prefectural Hospital
  • MINOHARA Shinichi
    Research Center for Charged Particle Therapy, National Institute of Radiological Sciences
  • MATSUFUJI Naruhiro
    Research Center for Charged Particle Therapy, National Institute of Radiological Sciences
  • MIZOE Junetsu
    CNAO Foundation, National Center for Oncological Hadrontherapy
  • FOSSATI Piero
    CNAO Foundation, National Center for Oncological Hadrontherapy University of Milan, Biomedical Sciences and Technologies Department
  • HASEGAWA Azusa
    Research Center for Charged Particle Therapy, National Institute of Radiological Sciences
  • KANAI Tatsuaki
    Heavy Ion Medical Center, Gunma University

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Abstract

Cerebral radionecrosis is a significant side effect in radiotherapy for brain cancer. The purpose of this study is to calculate the relative biological effectiveness (RBE) of carbon-ion beams on brain cells and to show RBE-weighted dose distributions for cerebral radionecrosis speculation in a carbon-ion treatment planning system. The RBE value of the radionecrosis for the carbon-ion beam is calculated by the modified microdosimetric kinetic model on the assumption of a typical clinical α/β ratio of 2 Gy for cerebral radionecrosis in X-rays. This calculation method for the RBE-weighted dose is built into the treatment planning system for the carbon-ion radiotherapy. The RBE-weighted dose distributions are calculated on computed tomography (CT) images of four patients who had been treated by carbon-ion radiotherapy for astrocytoma (WHO grade 2) and who suffered from necrosis around the target areas. The necrotic areas were detected by brain scans via magnetic resonance imaging (MRI) after the treatment irradiation. The detected necrotic areas are easily found near high RBE-weighted dose regions. The visual comparison between the RBE-weighted dose distribution and the necrosis region indicates that the RBE-weighted dose distribution will be helpful information for the prediction of radionecrosis areas after carbon-ion radiotherapy.

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