Advanced Physics for Brachytherapy 2018
Example: systematic uncertainties for target
effect of systematic underestimation of target D 90
on observed dose-response
100%
Systematic 1.5 mm applicator reconstruction uncertainty for MRI- based cervix BT (Tanderup et al., R&O 2008): e.g. D D90 ≤ +3%/fx => „observed“ local control @85 Gy <1% higher than model prediction
98%
96%
high dose, high rate of local control
94%
small targets, good coverage
92%
90%
TCP
Systematically larger contours on CT vs. MRI => underestimation of D90 by CT contours (e.g. Viswanathan et al. 2007, IJROBP 68):
88%
mean +3%
large targets, low coverage
86%
mean +5%
local control probability
e.g. i)
D D =+10%/fx => 2% overestimation of local control @ 85 Gy 90 =+20%/fx => 3.5% overestimation of local control @ 85 Gy 90 D D
84%
mean +10%
mean +20%
82%
ii)
model
80%
65
75
85
95
105
115
total treatment D 90
CTV HR
(EQD2
)
a/b =10Gy
(model based on preliminary retroEMBRACE data: Tanderup et al, GEC-ESTRO workshop, Brussels, 2013 )
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