First application of the BIANCA biophysical model to carbon-ion patient cases

Wioletta S Kozłowska; Mario P Carante; Giulia Aricò; Alessia Embriaco; Alfredo Ferrari; Giuseppe Magro; Andrea Mairani; Ricardo Ramos; Paola Sala; Dietmar Georg; Francesca Ballarini

doi:10.1088/1361-6560/ac702b

First application of the BIANCA biophysical model to carbon-ion patient cases

Phys Med Biol. 2022 May 27;67(11). doi: 10.1088/1361-6560/ac702b.

Authors

Wioletta S Kozłowska¹, Mario P Carante^{2

3}, Giulia Aricò⁴, Alessia Embriaco^{3

5}, Alfredo Ferrari^{6

7}, Giuseppe Magro⁸, Andrea Mairani^{8

9}, Ricardo Ramos³, Paola Sala¹⁰, Dietmar Georg¹, Francesca Ballarini^{2

3}

Affiliations

¹ Medical University of Vienna, Vienna, Austria.
² University of Pavia, Physics Department, Pavia, Italy.
³ INFN (Italian National Institute for Nuclear Physics), Sezione di Pavia, Pavia, Italy.
⁴ Optimization of Medical Accelerators, Warrington, United Kingdom.
⁵ ENEA-Casaccia, Roma, Italy.
⁶ University Hospital Heidelberg, Heidelberg, Germany.
⁷ Gangneung-Wonju National University, Gangneung 25457, Republic of Korea.
⁸ CNAO (Centro Nazionale di Adroterapia Oncologica), Pavia, Italy.
⁹ HIT (Heidelberg Ion-beam Therapy Center), Heidelberg, Germany.
¹⁰ INFN (Italian National Institute for Nuclear Physics), Sezione di Milano, Milano, Italy.

PMID: 35576922
DOI: 10.1088/1361-6560/ac702b

Abstract

Objective.The main objective of this work consists of applying, for the first time, the BIANCA (BIophysical ANalysis of Cell death and chromosome Aberrations) biophysical model to the RBE calculation for C-ion cancer patients, and comparing the outcomes with those obtained by the LEM I model, which is applied in clinics. Indeed, the continuous development of heavy-ion cancer therapy requires modelling of biological effects of ion beams on tumours and normal tissues. The relative biological effectiveness (RBE) of heavy ions is higher than that of protons, with a significant variation along the beam path. Therefore, it requires a precise modelling, especially for the pencil-beam scanning technique. Currently, two radiobiological models, LEM I and MKM, are in use for heavy ions in scanned pencil-beam facilities.Approach.Utilizing an interface with the FLUKA Particle Therapy Tool, BIANCA was applied to re-calculate the RBE-weighted dose distribution for carbon-ion treatment of three patients (chordoma, head-and-neck and prostate) previously irradiated at CNAO, where radiobiological optimization was based on LEM I. The predictions obtained by BIANCA were based either on chordoma cell survival (RBE_surv), or on dicentric aberrations in peripheral blood lymphocytes (RBE_ab), which are indicators of late normal tissue damage, including secondary tumours. The simulation outcomes were then compared with those provided by LEM I.Main results.While in the target and in the entrance channel BIANCA predictions were lower than those obtained by LEM I, the two models provided very similar results in the considered OAR. The observed differences betweenRBE_survandRBE_ab(which were also dependent on fractional dose and LET) suggest that in normal tissues the information on cell survival should be integrated by information more closely related to the induction of late damage, such as chromosome aberrations.Significance.This work showed that BIANCA is suitable for treatment plan optimization in ion-beam therapy, especially considering that it can predict both cell survival and chromosome aberrations and has previously shown good agreement with carbon-ion experimental data.

Keywords: BIANCA; RBE; carbon ion; heavy ion; particle therapy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carbon / therapeutic use
Chordoma*
Chromosome Aberrations
Heavy Ion Radiotherapy* / methods
Humans
Ions
Male
Radiotherapy Planning, Computer-Assisted / methods
Relative Biological Effectiveness

Substances

Ions
Carbon