Estimation of treatment efficiency of head-and-neck cancer based on tumour control probability model


  • Sukhikh Evgeniya Sergeevna
  • Sukhikh Leonid Grigorievich
  • Sutygina Yana Nikolaevna
  • Verkhoturova Vera Viktorovna
  • Sagov Islam Ruslanovich
  • Rozanov Vladimir Viktorovich



locally advanced head-and-neck cancer, volumetric modulated arc therapy, simultaneous integrated boost, tumour control probability model


External beam radiotherapy is widely used for the treatment of the locally advanced head-and-neck cancer (LAHNC). Analysis of the developed treatment plans based on tumour control probability (TCP) models could help to estimate expected treatment results of the developed plans and to find optimal treatment schemes with respect to total dose, fractional dose and overall treatment time (OTT). In this study, the simultaneous integrated boost VMAT (SIB-VMAT) plans and sequential boost VMAT (SEQ-VMAT) plans were developed based on the anatomical data of 11 patients. Methods and Material: The data of 11 patients with LAHNC (larynx, oropharynx and oral cavity) were used. For each patient two treatment plans were developed, SIB-VMAT (70 Gy to tumour, 50 Gy to lymph nodes, 25 fractions) and SEQ-VMAT (70 Gy to tumour, 50 Gy to lymph nodes, 35 fractions). The developed plans were analysed using the Niemierko’s TCP model with Maciejewski’s parameters (TCD50 = 70.26 Gy at 49-days OTT) taking into account dose-volume histograms and OTT. Results: The developed plans resulted in high clinical treatment volume (CTV) conformity (98%-98%) for all patients, except one. The average TCP value of SIB-VMAT was equal to 99.9% due to very short OTT. The average value of TCP for SEQ-VMAT was equal to 61.0%. For one patient, the both SIB-VMAT and SEQ-VMAT plans showed zero expected efficiency due to CTV coverage 95%-95%. Conclusions: Use of TCP models allows analysis of treatment plans for each particular patient and development of different treatment schemes with increase of the total dose value, fractional dose and shortening of OTT.


Kaprin AD, Starinsky VV, Petrova GV. Malignant tumours in Russia in 2017. Morbidity and mortality (in Russian); 2018. Available from: tumors/2017.pdf.

Beitler JJ, Zhang Q, Fu KK, Trotti A, Spencer SA, Jones CU, et al. Final results of local-regional control and late toxicity of rtog 9003: A randomized trial of altered fractionation radiation for locally advanced head and neck cancer. International Journal of Radiation Oncology Biology Physics. 2014;89(1):13–20.

Dragan T, Beauvois S, Moreau M, Paesmans M, Vandekerkhove C, Cordier L, et al. Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients. Oral Oncology. 2019;98:132–140.

Maciejewski B, Withers HR, Taylor JMG, Hliniak A. Dose fractionation and regeneration in radiotherapy for cancer of the oral cavity and oropharynx: Tumor dose-response and repopulation. International Journal of Radiation Oncology, Biology, Physics. 1989;16(3):831–

Tarnawski R, Fowler J, Skladowski K, Wierniak A, Suwi´nski R, Maciejewski B, et al. How

fast is repopulation of tumor cells during the treatment gap? International Journal of Radiation Oncology Biology Physics. 2002;54(1):229–236.

Orlandi E, Palazzi M, Pignoli E, Fallai C, Giostra A, Olmi P. Radiobiological basis and clinical results of the simultaneous integrated boost (SIB) in intensity modulated radiotherapy (IMRT) for head and neck cancer: A review. Critical Reviews in Oncology/Hematology. 2010;73(2):111–125.

Luxton G, Hancock SL, Boyer AL. Dosimetry and radiobiologic model comparison of IMRT and 3D conformal radiotherapy in treatment of carcinoma of the prostate. International Journal of Radiation Oncology Biology Physics. 2004;59(1):267–284.

Deb P, Fielding A. Radiobiological model comparison of 3D conformal radiotherapy and IMRT plans for the treatment of prostate cancer. Australasian Physical and Engineering Sciences in Medicine. 2009;32(2):51–61.

Chow JCL, Jiang R. Prostate volumetric-modulated arc therapy: Dosimetry and radiobiological model variation between the single-arc and double-arc technique. Journal of Applied Clinical Medical Physics. 2013;14(3):3–12.

Sukhikh ES, Sukhikh LG, Taletsky AV, Vertinsky AV, Izhevsky PV, Sheino IN. Influence of SBRT fractionation on TCP and NTCP estimations for prostate cancer. Physica Medica. 2019;62:41–46.

Niemierko A. Reporting and analyzing dose distributions: A concept of equivalent uniform

dose. Medical Physics. 1997;24(1):103–110.

Niemierko A. A unified model of tissue response to radiation. Medical Physics. 1999;26:1100.

Gay HA, Niemierko A. A free program for calculating EUD-based NTCP and TCP in external beam radiotherapy. Physica Medica. 2007;23(3-4):115–125.

Combifix. CIVKO Combifix; 2020. Available from:

Elekta Synergy. Elekta Synergy; 2020. Available from:

Rana S, Cheng C, Zhao L, Park S, Larson G, Vargas C, et al. Dosimetric and radiobiological impact of intensity modulated proton therapy and RapidArc planning for high-risk prostate cancer with seminal vesicles. Journal of Medical Radiation Sciences. 2017;64(1):18–24.

Wolfram. Wolfrmam Mathematica; 2020. Available from:

Chao KSC, Ozyigit G, Tran BN, Cengiz M, Dempsey JF, Low DA. Patterns of failure in patients receiving definitive and postoperative IMRT for head-and-neck cancer. International Journal of Radiation Oncology Biology Physics. 2003;55(2):312–321.

Spiotto MT, Weichselbaum RR. Comparison of 3D confromal radiotherapy and intensity modulated radiotherapy with or without simultaneous integrated boost during concurrent chemoradiation for locally advanced head and neck cancers. PLoS ONE. 2014;9(4).

Rastogi M, Sapru S, Gupta P, Gandhi AK, Mishra SP, Srivastava AK, et al. Prospective evaluation of Intensity Modulated Radiation Therapy with Simultaneous Integrated Boost (IMRT-SIB) in head and neck squamous cell carcinoma in patients not suitable for chemoradiotherapy. Oral Oncology. 2017;67:10–16.

Vlacich G, Stavas MJ, Pendyala P, Chen SC, Shyr Y, Cmelak AJ. A comparative analysis between sequential boost and integrated boost intensity-modulated radiation therapy with concurrent chemotherapy for locally-advanced head and neck cancer. Radiation Oncology.


Vanasek J, Odrazka K, Dusek L, Jarkovsky J, Michalek R, Chrobok V, et al. Experience with intensity-modulated radiotherapy in the treatment of head and neck cancer. Journal of BUON. 2013;18(4):970–976.

De Arruda FF, Puri DR, Zhung J, Narayana A, Wolden S, Hunt M, et al. Intensity-modulated radiation therapy for the treatment of oropharyngeal carcinoma: The Memorial Sloan-Kettering Cancer Center experience. International Journal of Radiation Oncology Biology Physics. 2006;64(2):363–373.

Guerrero Urbano T, Clark CH, Hansen VN, Adams EJ, A’Hern R, Miles EA, et al. A phase I study of dose-escalated chemoradiation with accelerated intensity modulated radiotherapy in locally advanced head and neck cancer. Radiotherapy and Oncology. 2007;85(1):36–41.

Farrag A, Voordeckers M, Tournel K, De Coninck P, Storme G. Pattern of failure after helical tomotherapy in head and neck cancer. Strahlentherapie und Onkologie. 2010;186(9):511–516.

Bigelow EO, Seiwert TY, Fakhry C. Deintensification of treatment for human papillomavirus-related oropharyngeal cancer: Current state and future directions. Oral Oncology. 2020;105.

Fakhry C, Zhang Q, Gillison ML, Nguyen-Tˆan PF, Rosenthal DI, Weber RS, et al. Validation of NRG oncology/RTOG-0129 risk groups for HPV-positive and HPV-negative oropharyngeal squamous cell cancer: Implications for risk-based therapeutic intensity trials. Cancer. 2019;125(12):2027–2038.

Overgaard J, Hansen HS, Specht L, Overgaard M, Grau C, Andersen E, et al. Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: DAHANCA 6&7 randomised controlled trial. Lancet. 2003;362(9388):933–940.




How to Cite

Sergeevna, S. E., Grigorievich, S. L., Nikolaevna, S. Y., Viktorovna, V. V., Ruslanovich, S. I., & Viktorovich, R. V. (2023). Estimation of treatment efficiency of head-and-neck cancer based on tumour control probability model. South Florida Journal of Development, 4(1), 248–263.