Influence of physical and radiobiological models on evaluation of radiotherapy treatment fractionation schedules for GBM brain tumours

Abstract

This study aims to evaluate the radiotherapy planning performance considering the clinical results of glioblastoma multiforme (GBM)-treated patients from both physical and radiobiological perspectives. Radiotherapy plans are done for 20 patients with GBM tumors who have received radical VMAT treatment on Eclipse-13.5. Dosimetric and radiobiological evaluation metrics are estimated to compare the two plans in terms of TCP, NTCP, and P+ in the context of the evaluated physical metrics. Both conventional and hypofractionation give better dose homogeneity and conformity to the tumour. In addition, hypofractionation schedule coverage targets cells with radiation doses higher than conventional schemes. However, both schedules are at acceptable and safe levels. Statistically, the calculated metrics showed good significance between conventional and hypofractionated radiotherapy schedules. The results have led to the safe use of hypofractionated radiotherapy that can be extended for different tumours, which helps in breaking down the waiting list of patients in many hospitals, especially in cases of pandemics such as COVID-19.