© International Commission on Radiation Units and Measurements 2007
2 RADIATION BIOLOGY CONSIDERATIONS
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2.1 INTRODUCTION
The rationale for proton therapy relates primarily to improved physical dose selectivity. Little clinical benefit is to be expected from selective radiobiological effects. Nevertheless, the relative biological effectiveness (RBE) of protons relative to high-energy (1–30 MeV) photons is significantly greater than unity. This fact immediately poses two questions: what is the best RBE estimate to be used in any calculation relating proton and photon doses, and how should proton doses be prescribed, recorded, and reported? Both of these subjects are discussed in the present section beginning with a discussion of the role of microdosimetry as a predictor of RBE. This will be followed by an evaluation of the available in vitro and in vivo information on proton RBE values, which leads to a
2.2 MICRODOSIMETRY AND LINEAR ENERGY TRANSFER
2.3 REVIEW OF PUBLISHED PROTON RBE VALUES
2.3.1 RBE values determined using in vitro and in vivo systems
2.3.2 RBE versus depth for 60–250 MeV beams
2.3.2.1 60–85 MeV
2.3.2.2 160–250 MeV
2.3.2.3 RBE on the declining distal edge of the SOBP
2.4 USE OF A GENERIC RBE VALUE
2.5 DOSE SPECIFICATION
2.5.1 The RBE-weighted absorbed dose (DRBE)
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