Cargando…

Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma

SUMMARY: Skin cancer patients may be treated definitively using radiation therapy (RT) with electrons, kilovoltage, or megavoltage photons depending on tumor stage and invasiveness. This study modeled tumor control probability (TCP) based on the pooled clinical outcome data of RT for primary basal a...

Descripción completa

Detalles Bibliográficos
Autores principales: Prior, Phillip, Awan, Musaddiq J., Wilson, J Frank, Li, X. Allen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165325/
https://www.ncbi.nlm.nih.gov/pubmed/34079752
http://dx.doi.org/10.3389/fonc.2021.621641
_version_ 1783701296168042496
author Prior, Phillip
Awan, Musaddiq J.
Wilson, J Frank
Li, X. Allen
author_facet Prior, Phillip
Awan, Musaddiq J.
Wilson, J Frank
Li, X. Allen
author_sort Prior, Phillip
collection PubMed
description SUMMARY: Skin cancer patients may be treated definitively using radiation therapy (RT) with electrons, kilovoltage, or megavoltage photons depending on tumor stage and invasiveness. This study modeled tumor control probability (TCP) based on the pooled clinical outcome data of RT for primary basal and cutaneous squamous cell carcinomas (BCC and cSCC, respectively). Four TCP models were developed and found to be potentially useful in developing optimal treatment schemes based on recommended ASTRO 2020 Skin Consensus Guidelines for primary, keratinocyte carcinomas (i.e. BCC and cSCC). BACKGROUND: Radiotherapy (RT) with electrons or photon beams is an excellent primary treatment option for keratinocyte carcinoma (KC), particularly for non-surgical candidates. Our objective is to model tumor control probability (TCP) based on the pooled clinical data of primary basal and cutaneous squamous cell carcinomas (BCC and cSCC, respectively) in order to optimize treatment schemes. METHODS: Published reports citing crude estimates of tumor control for primary KCs of the head by tumor size (diameter: ≤2 cm and >2 cm) were considered in our study. A TCP model based on a sigmoidal function of biological effective dose (BED) was proposed. Three-parameter TCP models were generated for BCCs ≤2 cm, BCCs >2cm, cSCCs ≤2 cm, and cSCCs >2 cm. Equivalent fractionation schemes were estimated based on the TCP model and appropriate parameters. RESULTS: TCP model parameters for both BCC and cSCC for tumor sizes ≤2 cm and >2cm were obtained. For BCC, the model parameters were found to be TD(50) = 56.62 ± 6.18 × 10(-3) Gy, k = 0.14 ± 2.31 × 10(−2) Gy(−1) and L = 0.97 ± 4.99 × 10(−3) and TD(50) = 55.78 ± 0.19 Gy, k = 1.53 ± 0.20 Gy(−1) and L = 0.94 ± 3.72 × 10(−3) for tumor sizes of ≤2 cm and >2 cm, respectively. For SCC the model parameters were found to be TD(50) = 56.81 ± 19.40 × 10(4) Gy, k = 0.13 ± 7.92 × 10(4) Gy(−1) and L = 0.96 ± 1.31 × 10(-2) and TD(50) = 58.44 ± 0.30 Gy, k = 2.30 ± 0.43 Gy(−1) and L = 0.91± 1.22 × 10(−2) for tumors ≤2cm and >2 cm, respectively. The TCP model with the derived parameters predicts that radiation regimens with higher doses, such as increasing the number of fractions and/or dose per fraction, lead to higher TCP, especially for KCs >2 cm in size. CONCLUSION: Four TCP models for primary KCs were developed based on pooled clinical data that may be used to further test the recommended kV and MV x-ray and electron RT regimens from the 2020 ASTRO guidelines. Increasing both number of fractions and dose per fraction may have clinically significant effects on tumor control for tumors >2 cm in size for both BCC and cSCC.
format Online
Article
Text
id pubmed-8165325
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-81653252021-06-01 Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma Prior, Phillip Awan, Musaddiq J. Wilson, J Frank Li, X. Allen Front Oncol Oncology SUMMARY: Skin cancer patients may be treated definitively using radiation therapy (RT) with electrons, kilovoltage, or megavoltage photons depending on tumor stage and invasiveness. This study modeled tumor control probability (TCP) based on the pooled clinical outcome data of RT for primary basal and cutaneous squamous cell carcinomas (BCC and cSCC, respectively). Four TCP models were developed and found to be potentially useful in developing optimal treatment schemes based on recommended ASTRO 2020 Skin Consensus Guidelines for primary, keratinocyte carcinomas (i.e. BCC and cSCC). BACKGROUND: Radiotherapy (RT) with electrons or photon beams is an excellent primary treatment option for keratinocyte carcinoma (KC), particularly for non-surgical candidates. Our objective is to model tumor control probability (TCP) based on the pooled clinical data of primary basal and cutaneous squamous cell carcinomas (BCC and cSCC, respectively) in order to optimize treatment schemes. METHODS: Published reports citing crude estimates of tumor control for primary KCs of the head by tumor size (diameter: ≤2 cm and >2 cm) were considered in our study. A TCP model based on a sigmoidal function of biological effective dose (BED) was proposed. Three-parameter TCP models were generated for BCCs ≤2 cm, BCCs >2cm, cSCCs ≤2 cm, and cSCCs >2 cm. Equivalent fractionation schemes were estimated based on the TCP model and appropriate parameters. RESULTS: TCP model parameters for both BCC and cSCC for tumor sizes ≤2 cm and >2cm were obtained. For BCC, the model parameters were found to be TD(50) = 56.62 ± 6.18 × 10(-3) Gy, k = 0.14 ± 2.31 × 10(−2) Gy(−1) and L = 0.97 ± 4.99 × 10(−3) and TD(50) = 55.78 ± 0.19 Gy, k = 1.53 ± 0.20 Gy(−1) and L = 0.94 ± 3.72 × 10(−3) for tumor sizes of ≤2 cm and >2 cm, respectively. For SCC the model parameters were found to be TD(50) = 56.81 ± 19.40 × 10(4) Gy, k = 0.13 ± 7.92 × 10(4) Gy(−1) and L = 0.96 ± 1.31 × 10(-2) and TD(50) = 58.44 ± 0.30 Gy, k = 2.30 ± 0.43 Gy(−1) and L = 0.91± 1.22 × 10(−2) for tumors ≤2cm and >2 cm, respectively. The TCP model with the derived parameters predicts that radiation regimens with higher doses, such as increasing the number of fractions and/or dose per fraction, lead to higher TCP, especially for KCs >2 cm in size. CONCLUSION: Four TCP models for primary KCs were developed based on pooled clinical data that may be used to further test the recommended kV and MV x-ray and electron RT regimens from the 2020 ASTRO guidelines. Increasing both number of fractions and dose per fraction may have clinically significant effects on tumor control for tumors >2 cm in size for both BCC and cSCC. Frontiers Media S.A. 2021-05-17 /pmc/articles/PMC8165325/ /pubmed/34079752 http://dx.doi.org/10.3389/fonc.2021.621641 Text en Copyright © 2021 Prior, Awan, Wilson and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Prior, Phillip
Awan, Musaddiq J.
Wilson, J Frank
Li, X. Allen
Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma
title Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma
title_full Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma
title_fullStr Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma
title_full_unstemmed Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma
title_short Tumor Control Probability Modeling for Radiation Therapy of Keratinocyte Carcinoma
title_sort tumor control probability modeling for radiation therapy of keratinocyte carcinoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165325/
https://www.ncbi.nlm.nih.gov/pubmed/34079752
http://dx.doi.org/10.3389/fonc.2021.621641
work_keys_str_mv AT priorphillip tumorcontrolprobabilitymodelingforradiationtherapyofkeratinocytecarcinoma
AT awanmusaddiqj tumorcontrolprobabilitymodelingforradiationtherapyofkeratinocytecarcinoma
AT wilsonjfrank tumorcontrolprobabilitymodelingforradiationtherapyofkeratinocytecarcinoma
AT lixallen tumorcontrolprobabilitymodelingforradiationtherapyofkeratinocytecarcinoma