ArticleThe British journal of radiology2016
Why RBE must be a variable and not a constant in proton therapy.
Article in The British journal of radiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ensemble RBE Modeling in Proton Therapy: A Meta-Synthesis Framework for Dose Assessment in the Brainstem and Spinal Cord.Cancer control : journal of the Moffitt Cancer CenterPooled it
- Neural network modelling of proton RBE values at predominant survival fractions of in vitro data.Scientific reports · 2026Article
- Variable Relative Biological Effectiveness of Protons in the Rat Spinal Cord: Measurements and Comparison With Model Calculations.Advances in radiation oncology · 2025Article
- Proton- compared to X-irradiation leads to more acinar atrophy and greater hyposalivation accompanied by a differential cytokine response.Scientific reports · 2024Article
- Particle Beam Radiobiology Status and Challenges: A PTCOG Radiobiology Subcommittee Report.International journal of particle therapy · 2024Review
- A Review of Numerical Models of Radiation Injury and Repair Considering Subcellular Targets and the Extracellular Microenvironment.International journal of molecular sciences · 2024Review
- Review
- Proton Compared to X-Irradiation Induces Different Protein Profiles in Oral Cancer Cells and Their Derived Extracellular Vesicles.International journal of molecular sciences · 2023Article
- More than Five Decades of Proton Therapy: A Bibliometric Overview of the Scientific Literature.Cancers · 2023Article
- Review
- Quantification of damage to plasmid DNA from 35 MeV electrons, 228 MeV protons and 300 kVp X-rays in varying hydroxyl radical scavenging environments.Journal of radiation research · 2023Article
- Activation of efficient DNA repair mechanisms after photon and proton irradiation of human chondrosarcoma cells.Scientific reports · 2021Article
- Moving Forward in the Next Decade: Radiation Oncology Sciences for Patient-Centered Cancer Care.JNCI cancer spectrum · 2021Article
- Update of the particle irradiation data ensemble (PIDE) for cell survival.Journal of radiation research · 2021Article
- First theoretical determination of relative biological effectiveness of very high energy electrons.Scientific reports · 2021Article
- Heavy charged particle beam therapy and related new radiotherapy technologies: The clinical potential, physics and technical developments required to deliver benefit for patients with cancer.The British journal of radiology · 2020Review
- Silicon 3D Microdetectors for Microdosimetry in Hadron Therapy.Micromachines · 2020Review
- Investigating the impact of alpha/beta and LETMedical physics · 2020Article
- Dose-Volume and Radiobiological Model-Based Comparative Evaluation of the Gastrointestinal Toxicity Risk of Photon and Proton Irradiation Plans in Localized Pancreatic Cancer Without Distant Metastasis.Frontiers in oncology · 2020Article
- Clinical Radiobiology of Fast Neutron Therapy: What Was Learnt?Frontiers in oncology · 2020Review
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThis article considered why the proton therapy (PT) relative biological effect (RBE) should be a variable rather than a constant.
methodsThe reasons for a variable proton RBE are enumerated, with qualitative and quantitative arguments. The heterogeneous data sets collated by Paganetti et al (2002) and the more homogeneous data of Britten et al (2013) are further analyzed using linear regression fitting and RBE-inclusive adaptations of the linear-quadratic (LQ) radiation model.
resultsThe in vitro data show RBE increasing as dose per fraction is lowered. In the Paganetti et al (2002) data sets, the differences between observed and expected effects are smaller when the LQ model is used, but with such data heterogeneity, firm statistical conclusions cannot be obtained. The more homogeneous data set shows an unequivocal variation in RBE with dose per faction. The in vivo data are inappropriate for assessments of late normal tissue effects in radiotherapy. Also, if there is the same degree of uncertainty in an RBE of 1.1 or in an RBE of 2-3 for C ions, the fractional and biological effective doses can vary considerably and be greater in the proton case. So, errors in RBE assignment are important for protons, just as with C ions.
conclusionFurther experimental programmes are proposed, including late normal tissue end points. Better RBE allocations might further improve PT outcomes. ADVANCES IN KNOWLEDGE: This study provides a rigorous critique of the 1.1 RBE used for protons, from theoretical and practical standpoints. Data analysis shows that the LQ model is more appropriate than simple linear regression. Comprehensive research programmes are suggested.
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