最近的实验研究和临床试验结果可能表明，至少对于某些适应症，继续使用欧洲碳离子治疗设施几十年来应用的相对生物有效性（RBE）机制模型（LEM-I）可能是没有根据的。我们提出了一种基于粒子治疗的改良微剂量动力学模型 (mMKM) 的前列腺癌治疗计划和肿瘤控制概率 (TCP) 预测的新颖临床框架。91 名前列腺肿瘤患者的治疗计划（质子：46，碳离子：45）使用 mMKM ((α/β)x=3.1Gy) 重新计算 20 个级分中的 66GyRBE [对于质子和 LEM-I，(α/β)x=2.0Gy，对于碳离子，RBE=1.1]。仅根据根据 ADT 风险和使用情况分层的光子照射患者组的反应数据，我们得出了基于 mMKM 的 Poisson-TCP 模型的参数。随后，遵循规定的生物剂量标准，制定了新的碳和氦离子计划。将这些结果与日本中心采用类似分馏方案和现有质子计划的临床经验进行系统比较。mMKM 预测表明质子和碳离子臂之间存在显着的生物剂量偏差。用质子照射的患者接受3.25±0.08GyRBEmMKM/Fx，而用碳离子治疗的患者接受2.51±0.05GyRBEmMKM/Fx。质子的 TCP 预测为 86±3%，碳离子的 TCP 预测为 52±4%，与 85% 和 50% 的临床结果相匹配。新优化的碳离子计划在 mMKM/TCP 模型的指导下，有效复制了日本中心的临床数据。使用 mMKM，氦离子表现出与质子和碳离子相似的目标覆盖范围，与质子相比，直肠和膀胱的保护得到改善。我们基于 mMKM 的前列腺癌治疗计划和 TCP 预测模型根据质子和碳离子治疗的临床数据进行了验证，其应用扩展到氦离子疗法。根据这项工作中提供的数据，mMKM 似乎是前列腺癌碳离子治疗临床生物学计算的良好候选者。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Recent experimental studies and clinical trial results might indicate that - at least for some indications - continued use of the mechanistic model for relative biological effectiveness (RBE) applied at carbon ion therapy facilities in Europe for several decades (LEM-I) may be unwarranted. We present a novel clinical framework for prostate cancer treatment planning and tumor control probability (TCP) prediction based on the modified microdosimetric kinetic model (mMKM) for particle therapy.Treatment plans of 91 prostate tumor patients (proton: 46, carbon ions: 45) applying 66GyRBE [RBE=1.1 for protons and LEM-I, (α/β)x=2.0Gy, for carbon ions] in 20 fractions were recalculated using mMKM ((α/β)x=3.1Gy). Based solely on the response data of photon-irradiated patient groups stratified according to risk and usage of ADT, we derived parameters for an mMKM-based Poisson-TCP model. Subsequently, new carbon and helium ion plans, adhering to prescribed biological dose criteria, were generated. These were systematically compared to the clinical experience of Japanese centers employing an analogous fractionation scheme and existing proton plans.mMKM predictions suggested significant biological dose deviation between proton and carbon ion arms. Patients irradiated with protons received 3.25±0.08GyRBEmMKM/Fx, while patients treated with carbon ions received 2.51±0.05GyRBEmMKM/Fx. TCP predictions were 86±3% for protons and 52±4% for carbon ions, matching the clinical outcome of 85% and 50%. Newly optimized carbon ion plans, guided by the mMKM/TCP model, effectively replicated clinical data from Japanese centers. Using mMKM, helium ions exhibited similar target coverage as proton and carbon ions and an improved rectum and bladder sparing compared to proton.Our mMKM-based model for prostate cancer treatment planning and TCP prediction was validated against clinical data for proton and carbon ion therapy and its application was extended to helium ion therapy. Based on the data presented in this work, mMKM seems to be a good candidate for clinical biological calculations in carbon ion therapy for prostate cancer.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.