Letter to the Editor. Biologically effective dose and the treatment of AVMs

John W. Hopewell DSc, FBIR6, Ian Paddick MSc7, Bleddyn Jones MD, ScD6,8, and Thomas Klinge MSc9,10
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  • 6 Green Templeton College, University of Oxford, United Kingdom
  • | 7 Gamma Knife Centre, National Hospital for Neurology and Neurosurgery, London, United Kingdom
  • | 8 Gray Laboratory, CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, United Kingdom
  • | 9 Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, United Kingdom
  • | 10 Centre for Medical Image Computing, University College London, United Kingdom
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Contributor Notes

Correspondence John W. Hopewell: john.hopewell@gtc.ox.ac.uk.

INCLUDE WHEN CITING Published online January 22, 2021; DOI: 10.3171/2020.9.JNS203545.

Disclosures Mr. Paddick: consultant for Elekta AB.

  • 1

    Tuleasca C , Peciu-Florianu I , Leroy H-A , et al. Biologically effective dose and prediction of obliteration of unruptured arteriovenous malformations treated by upfront Gamma Knife radiosurgery: a series of 149 consecutive cases . J Neurosurg. Published online July 24 , 2020 . doi:10.3171/2020.4.JNS201250

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  • 2

    Hopewell JW , Millar WT , Lindquist C . Radiobiological principles: their application to γ knife therapy . Prog Neurol Surg . 2012 ;25 :39 54 .

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  • 3

    Hopewell JW , Millar WT , Lindquist C , et al. Application of the concept of biologically effective dose (BED) to patients with vestibular schwannomas treated by radiosurgery . J Radiosurg SBRT . 2013 ;2 (4 ):257 271 .

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  • 4

    Millar WT , Hopewell JW , Paddick I , et al. The role of the concept of biologically effective dose (BED) in treatment planning in radiosurgery . Phys Med . 2015 ;31 (6 ):627 633 .

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  • 5

    Tuleasca C , Paddick I , Hopewell JW , et al. Establishment of a therapeutic ratio for Gamma Knife radiosurgery of trigeminal neuralgia: the critical importance of biologically effective dose versus physical dose . World Neurosurg . 2020 ;134 :e204 e213 .

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  • 6

    Régis J , Tuleasca C , Hopewell JW , Castinetti F . Commentary: The impact of insulin-like growth factor index and biologically effective dose on outcomes after stereotactic radiosurgery for acromegaly: cohort study . Neurosurgery . 2020 ;87 (3 ):E301 E302 .

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  • 7

    Millar WT , Canney PA . Derivation and application of equations describing the effects of fractionated protracted irradiation, based on multiple and incomplete repair processes. Part I. Derivation of equations . Int J Radiat Biol . 1993 ;64 (3 ):275 291 .

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    • Export Citation
  • 8

    Jones B , Hopewell JW . Modelling the influence of treatment time on the biological effectiveness of single radiosurgery treatments: derivation of “protective” dose modification factors . Br J Radiol . 2019 ;92 (1093 ):20180111 .

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  • 9

    Klinge T , Modat M , McClelland , et al. The impact of unscheduled gaps and iso-centre sequencing on the biologically effective dose in Gamma Knife radiosurgery . J Radiosurg SBRT . In press .

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  • 10

    Graffeo CS , Donegan D , Erickson D , et al. The impact of insulin-like growth factor index and biologically effective dose on outcomes after stereotactic radiosurgery for acromegaly: cohort study . Neurosurgery . 2020 ;87 (3 ):538 546 .

    • Search Google Scholar
    • Export Citation
  • 1

    Karlsson B , Lax I , Yamamoto M , et al. Calculation of isoeffective doses and the alpha/beta value by comparing results following radiosurgery and radiotherapy for arteriovenous malformations of the brain . J Neurosurg . 2006 ;105 (suppl ):183 189 .

    • Search Google Scholar
    • Export Citation
  • 2

    Larson DA , Flickinger JC , Loeffler JS . The radiobiology of radiosurgery . Int J Radiat Oncol Biol Phys . 1993 ;25 (3 ):557 561 .

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    • Export Citation
  • 3

    Hopewell JW , Millar WT , Lindquist C , et al. Application of the concept of biologically effective dose (BED) to patients with vestibular schwannomas treated by radiosurgery . J Radiosurg SBRT . 2013 ;2 (4 ):257 271 .

    • Search Google Scholar
    • Export Citation
  • 4

    Tuleasca C , Paddick I , Hopewell JW , et al. Establishment of a therapeutic ratio for Gamma Knife radiosurgery of trigeminal neuralgia: the critical importance of biologically effective dose versus physical dose . World Neurosurg . 2020 ;134 :e204 e213 .

    • Search Google Scholar
    • Export Citation
  • 5

    Millar WT , Hopewell JW , Paddick I , et al. The role of the concept of biologically effective dose (BED) in treatment planning in radiosurgery . Phys Med . 2015 ;31 (6 ):627 633 .

    • Search Google Scholar
    • Export Citation
  • 6

    Régis J , Tuleasca C , Hopewell JW , Castinetti F . Commentary: The impact of insulin-like growth factor index and biologically effective dose on outcomes after stereotactic radiosurgery for acromegaly: cohort study . Neurosurgery . 2020 ;87 (3 ):E301 E302 .

    • Search Google Scholar
    • Export Citation
  • 7

    Regis J , Tamura M , Guillot C , et al. Radiosurgery with the world’s first fully robotized Leksell Gamma Knife PerfeXion in clinical use: a 200-patient prospective, randomized, controlled comparison with the Gamma Knife 4C . Neurosurgery . 2009 ;64 (2 ):346 356 .

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  • 8

    Moeller BJ , Dreher MR , Rabbani ZN , et al. Pleiotropic effects of HIF-1 blockade on tumor radiosensitivity . Cancer Cell . 2005 ;8 (2 ):99 110 .

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    • Export Citation
  • 1

    Millar WT , Canney PA . Derivation and application of equations describing the effects of fractionated protracted irradiation, based on multiple and incomplete repair processes. Part I. Derivation of equations . Int J Radiat Biol . 1993 ;64 (3 ):275 291 .

    • Search Google Scholar
    • Export Citation
  • 2

    Hall EJ , Brenner DJ . The radiobiology of radiosurgery: rationale for different treatment regimes for AVMs and malignancies . Int J Radiat Oncol Biol Phys . 1993 ;25 (2 ):381 385 .

    • Search Google Scholar
    • Export Citation
  • 3

    Jones B , Hopewell JW . Modelling the influence of treatment time on the biological effectiveness of single radiosurgery treatments: derivation of “protective” dose modification factors . Br J Radiol . 2019 ;92 (1093 ):20180111 .

    • Search Google Scholar
    • Export Citation
  • 4

    Millar WT , Hopewell JW , Paddick I , et al. The role of the concept of biologically effective dose (BED) in treatment planning in radiosurgery . Phys Med . 2015 ;31 (6 ):627 633 .

    • Search Google Scholar
    • Export Citation
  • 5

    Graffeo CS , Donegan D , Erickson D , et al. The impact of insulin-like growth factor index and biologically effective dose on outcomes after stereotactic radiosurgery for acromegaly: cohort study . Neurosurgery . 2020 ;87 (3 ):538 546 .

    • Search Google Scholar
    • Export Citation
  • 6

    Karlsson B , Lax I , Yamamoto M , et al. Calculation of isoeffective doses and the alpha/beta value by comparing results following radiosurgery and radiotherapy for arteriovenous malformations of the brain . J Neurosurg . 2006 ;105 (suppl ):183 189 .

    • Search Google Scholar
    • Export Citation

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