{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:05:31Z","timestamp":1789704331017,"version":"4.0.1"},"reference-count":20,"publisher":"IOP Publishing","issue":"4","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/page\/copyright"},{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Phys. Med. Biol."],"published-print":{"date-parts":[[2025,2,16]]},"abstract":"Abstract<\/jats:title>\n Using the concept of biologically effective dose (BED), the effect of sublethal DNA damage repair (SLR) on the bio-efficacy of prolonged radiotherapy treatments can be quantified (BEDSLR<\/jats:sub>). Such treatments, lasting more than 20 min, are typically encountered in stereotactic radiosurgery (SRS) applications using the CyberKnife (CK) and Gamma knife systems. Evaluating the plan data from 45 Vestibular Schwannoma (VS) cases treated with single fraction CK-SRS, this work demonstrates a statistically significant correlation between the marginal BEDSLR<\/jats:sub> delivered to the target (m-<\/jats:italic>BEDSLR<\/jats:sub>) and the ratio of the mean collimator size weighted by the fraction of total beams delivered with each collimator (\n \n \n \n \n \n w<\/mml:mi>\n m<\/mml:mi>\n <\/mml:msubsup>\n \n Cs<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>), to the tumor volume (Tv). The correlation between m-<\/jats:italic>BEDSLR<\/jats:sub> and \n \n \n \n \n \n \n \n w<\/mml:mi>\n m<\/mml:mi>\n <\/mml:msubsup>\n \n Cs<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:mrow>\n \n \n Tv<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:mfrac>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula> datasets was mathematically expressed by the power function \n \n \n \n m<\/mml:mi>\n \u2212<\/mml:mo>\n \n BE<\/mml:mtext>\n <\/mml:mrow>\n \n \n \n D<\/mml:mtext>\n <\/mml:mrow>\n \n \n SLR<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n =<\/mml:mo>\n 85.21<\/mml:mn>\n \n \u2009<\/mml:mtext>\n <\/mml:mrow>\n \n (<\/mml:mo>\n \n \u00b1<\/mml:mo>\n 1.7<\/mml:mn>\n %<\/mml:mi>\n <\/mml:mrow>\n )<\/mml:mo>\n <\/mml:mrow>\n \u22c5<\/mml:mo>\n \n \n \n (<\/mml:mo>\n \n \n \n \n \n w<\/mml:mi>\n m<\/mml:mi>\n <\/mml:msubsup>\n C<\/mml:mi>\n s<\/mml:mi>\n <\/mml:mrow>\n \n T<\/mml:mi>\n v<\/mml:mi>\n <\/mml:mrow>\n <\/mml:mfrac>\n <\/mml:mrow>\n )<\/mml:mo>\n <\/mml:mrow>\n \n \n (<\/mml:mo>\n \n 0.05<\/mml:mn>\n \u00b1<\/mml:mo>\n 7<\/mml:mn>\n %<\/mml:mi>\n <\/mml:mrow>\n )<\/mml:mo>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:msup>\n <\/mml:mrow>\n \n \u2009<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>enabling continuous m-<\/jats:italic>BEDSLR<\/jats:sub> predictions. Using this formula, a specific range of m-<\/jats:italic>BEDSLR<\/jats:sub> levels can a priori<\/jats:italic> be targeted during treatment planning through proper selection of collimator size(s) for a given tumor volume. Inversely, for a selected set of collimators, the optimization range of m-<\/jats:italic>BEDSLR<\/jats:sub> can be determined assuming that all beams are delivered with the smallest and largest collimator size. For single collimator cases or when the relative usage of each collimator size is known or estimated, a specific m-<\/jats:italic>BEDSLR<\/jats:sub> level can be predicted within 3% uncertainty. The proposed equation is valid for the fixed CK collimators and a physical dose prescription (D<\/jats:italic>\n pr<\/jats:sub>) of 13 Gy. For alternate D<\/jats:italic>\n pr<\/jats:sub> in the range of 11\u201314 Gy, a linear relationship was found between relative changes of m-<\/jats:italic>BEDSLR<\/jats:sub>(D<\/jats:italic>\n pr<\/jats:sub>) and D<\/jats:italic>\n pr<\/jats:sub> with respect to m-<\/jats:italic>BEDSLR<\/jats:sub>(13 Gy) and 13 Gy, respectively. The proposed methodology is simple and easy to implement in the clinical setting allowing for optimization of the treatment\u2019s bio-effectiveness, in terms of the delivered BED, during treatment planning.<\/jats:p>","DOI":"10.1088\/1361-6560\/adaf72","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T22:58:06Z","timestamp":1738105086000},"page":"04NT02","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A simple plan strategy to optimize the biological effective dose delivered in robotic radiosurgery of vestibular schwannomas"],"prefix":"10.1088","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9005-674X","authenticated-orcid":true,"given":"A","family":"Moutsatsos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-5407","authenticated-orcid":true,"given":"E","family":"Pantelis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"pmbadaf72bib1","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1016\/S1470-2045(19)30569-8","article-title":"Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial","volume":"20","author":"Brand","year":"2019","journal-title":"Lancet Oncol."},{"key":"pmbadaf72bib2","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1227\/01.NEU.0000159650.79833.2B","article-title":"Staged stereotactic irradiation for acoustic neuroma","volume":"56","author":"Chang","year":"2005","journal-title":"Neurosurgery"},{"key":"pmbadaf72bib3","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.ijrobp.2004.01.004","article-title":"Loss of biological effect in prolonged fraction delivery","volume":"59","author":"Fowler","year":"2004","journal-title":"Int. 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All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2024-10-07","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-01-28","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-02-06","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}