Application of the LQ model to the interpretation of absorbed dose distribution in the daily practice of radiotherapy.

Abstract

In 1991, the vast majority of radiotherapy centers are implemented with computer treatment planning systems (TPS), and it has become routine practice to compute full absorbed dose distribution (ADD) in almost all treatment situations. Usually the target is covered by the 100% isodose and the surrounding normal tissues receive a lesser dose than the tumor. It implies, that, as the dose per fraction of, say, 2 Gy is prescribed at the 100%, normal tissues receive a daily dose different than 2 Gy. The absorbed doses delivered at different organs have therefore not the same biological effectiveness and must be corrected according to the actual dose per fraction for a proper interpretation of the treatment planning. This is of great importance since most of the "tolerance levels" used in the practice have been determined for doses per fraction around 1.8-2 Gy. The linear-quadratic (LQ) model provides a simple method for establishing biological equivalencies and has been used throughout this article to establish the difference between the absorbed dose computed by the TPS and its biological equivalent. It is shown that normal tissues receiving less than 100% of the daily dose are relatively more protected than suggested by the ADD, and, inversely, that normal structures overdosed and thus receiving more than the 100% daily dose are relatively more at risk for complications than suggested from the ADD.