TH‐A‐BRD‐01: Radiation Biology for Radiation Therapy Physicists
Authors: Orton C , Borras C , Carlson D 
Published: July 2014

Mechanisms by which radiation kills cells and ways cell damage can be repaired will be reviewed. The radiobiological parameters of dose, fractionation, delivery time, dose rate, and LET will be discussed. The linear‐quadratic model for cell survival for high and low dose rate treatments and the effect of repopulation will be presented and discussed. The rationale for various radiotherapy techniques such as conventional fractionation, hyperfractionation, hypofractionation, and low and high dose rate brachytherapy, including permanent implants, will be presented.

The radiobiological principles underlying radiation protection guidelines and the different radiation dosimetry terms used in radiation biology and in radiation protection will be reviewed. Human data on radiation induced cancer, including increases in the risk of second cancers following radiation therapy, as well as data on radiation induced tissue reactions, such as cardiovascular effects, for follow up times up to 20–40 years, published by ICRP, NCRP and BEIR Committees, will be examined. The latest risk estimates per unit dose will be presented. Their adoption in recent radiation protection standards and guidelines and their impact on patient and workers safety in radiotherapy will be discussed.

Biologically‐guided radiotherapy (BGRT) provides a systematic method to derive prescription doses that integrate patient‐specific information about tumor and normal tissue biology. Treatment individualization based on patient‐specific biology requires the identification of biological objective functions to facilitate the design and comparison of competing treatment modalities. Biological objectives provide a more direct approach to plan optimization instead of relying solely on dose‐based surrogates and can incorporate factors that alter radiation response, such as DNA repair, tumor hypoxia, and relative biological effectiveness. We review concepts motivating biological objectives and provide examples of how they might be used to address clinically relevant problems. Underlying assumptions and limitations of existing models and their proper application will be discussed.

This multidisciplinary educational session combines the fundamentals of radiobiology for radiation therapy and radiation protection with the practical application of biophysical models for treatment planning and evaluation.

Learning Objectives:

To understand fractionation in teletherapy and dose rate techniques in brachytherapy.

To understand how the linear‐quadratic models the effect of radiobiological parameters for radiotherapy.

To understand the radiobiological basis of radiation protection standards applied to radiotherapy.

To distinguish between stochastic effects and tissue reactions.

To learn how to apply concepts of biological effective dose and RBE‐weighted dose and to incorporate biological factors that alter radiation response.

To discuss clinical strategies to increase therapeutic ratio, i.e., maximize local control while minimizing the risk of acute and late normal tissue effects.