Calibrating absolute malignant induction probabilities into life-time attributable risk
Conference Paper
Madkhali, Abdossalam M . 2016
نوع عمل المنشور:
Poster
اسم المؤتمر:
ESTRO 35
عنوان المؤتمر:
Turin, Italy
تاريخ المؤتمر:
الجمعة, نيسان (أبريل) 29, 2016
مستخلص المنشور:
Purpose or Objective
More than half of cancer patients receive radiotherapy for radical or palliative purposes. Increasing survival rates in cancer patients make it important to study late side-effects, including secondary radiation-induced cancers. Although a number of predictive models exist, the absolute accuracy of these models in the radiotherapy dose range is limited partly due to scarcity of data and partly by extrapolation beyond historical data bounds. The aim of this work is to investigate conversion of malignant induction probabilities, which provide useful relative risk estimates, into absolute life time attributable risk estimates (LAR) and excess absolute risk (EAR) by calibrating and benchmarking our models using published outcome data.
Material and Methods
An in-house modelling tool, which calculates voxelwise risk estimates from patient-specific 3D dose distributions, was modified to generate linear-no-threshold (LNT) model-based risk estimates for the whole body and per organ using organ-equivalent dose. Second cancer risk was calculated for uniform whole-body exposure of 0.1 Gy for comparison with tabulated BIER VII data. Model parameters initially used were taken from existing published reports for the relevant models. The calculated LAR was then compared to the BIER VII results and the linear coefficient, λ, was adjusted to make the model prediction better match the BEIR VII result. A similar calibration of parameters was then performed for the linear quadratic (LQ) and linear model (LIN) malignant induction coefficients. EAR was calculated for a dose range to compare results with published data.
Results
After calibration, calculations of LAR for single uniform exposure of 0.1 Gy produced a value of 837 cases per 100,000 for an exposure at age of 40, in comparison to 824 according to BIER VII report. Averaging over ages at exposure of 20 to 80 produced a value within 5% of the BIER VII report. Calculations of EAR for a dose range relevant to RT of 1-6 Gy using the LIN model were always within the range of uncertainty due to differences in RBE neutron value in the independent published Hodgkin Lymphoma data (Schneider et al, 2008).
Conclusion
These results show that our models can produce absolute LAR estimates for secondary cancer which are consistent with the values reported in the BEIR VII report for uniform irradiation to 0.1Gy. The comparison of our results of EAR using LIN model to published data showed agreement with independent published data of HL.