Multi‐modality biological dose optimization for combined carbon‐ion and proton radiation therapy

作者：Chao Wang, Yanan Zhu, Yu-Ting Lin, Bo Lu, Jun Tan, Wangyao Li, Hao Gao · 发表于：Medical Physics · 年份：2025 · DOI：10.1002/mp.70077 · 被引用次数：3 · 研究领域：Radiation Therapy and Dosimetry、Effects of Radiation Exposure、Advanced Radiotherapy Techniques

BACKGROUND: Carbon ion radiotherapy (CIRT), characterized by its Bragg peak and a reduced lateral scattering compared to proton radiotherapy (PT), offers excellent dose conformity in radiation treatment. Meanwhile, compared to PT, CIRT causes more complex and severe DNA damage in tumor cells, which results in a higher relative biological effectiveness (RBE), making it particularly advantageous in treating radioresistant and hypoxia tissues than conventional radiotherapy. However, CIRT's high RBE and the nuclear fragmentation dose tail outside the target presents challenges in sparing organ at risk (OARs). Combining PT and CIRT offers a potential hybrid modality that leverages the biological effectiveness of carbon ions while minimizing normal tissue toxicity with high biological damage. PURPOSE: Despite the potential of combining PT and CIRT, balancing their respective advantages while mitigating disadvantages remains a significant challenge. This study aims to develop an optimized treatment approach that automatically adjusts the relative contributions of protons and carbon ions, improving target dose conformity while minimizing biological impact on OARs. METHODS: We propose a biological optimization framework for multi-modality combining PT and CIRT (CCIPRT). The biological dose is modeled as the product of the physical dose and RBE. Through iterative Jacobian-based linearization, the biological dose of carbon ion is expressed in a linear model, enabling the formulation of ...