Table of Contents
ISRN Oncology
Volume 2013, Article ID 527251, 5 pages
http://dx.doi.org/10.1155/2013/527251
Research Article

Radiobiological Framework for the Evaluation of Stereotactic Radiosurgery Plans for Invasive Brain Tumours

1Medical Radiation Physics, Stockholm University and Karolinska Institutet, 171 76 Stockholm, Sweden
2Department of Radiation Physics UHL, County Council of Östergötland, Linköping University, 581 85 Linköping, Sweden

Received 21 August 2013; Accepted 18 October 2013

Academic Editors: S. T. Chao, A. Goussia, G. Metro, and S. Mohanam

Copyright © 2013 Helena Sandström et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study presents a radiobiological formalism for the evaluation of the treatment plans with respect to the probability of controlling tumours treated with stereotactic radiosurgery accounting for possible infiltrations of malignant cells beyond the margins of the delineated target. Treatments plans devised for three anaplastic astrocytoma cases were assumed for this study representing cases with different difficulties for target coverage. Several scenarios were considered regarding the infiltration patterns. Tumour response was described in terms of tumour control probability (TCP) assuming a Poisson model taking into account the initial number of clonogenic cells and the cell survival. The results showed the strong impact of the pattern of infiltration of tumour clonogens outside the delineated target on the outcome of the treatment. The treatment plan has to take into account the existence of the possible microscopic disease around the visible lesion; otherwise the high gradients around the target effectively prevent the sterilisation of the microscopic spread leading to low probability of control, in spite of the high dose delivered to the target. From this perspective, the proposed framework offers a further criterion for the evaluation of stereotactic radiosurgery plans taking into account the possible infiltration of tumour cells around the visible target.