Toward a comprehensive personalized circulating blood irradiation model in radiotherapy
- Autores: Marina García Cardosa
- Directores de la Tesis: Francisco Javier Burguete Mas (dir. tes.)
- Lectura: En la Universidad de Navarra ( España ) en 2025
- Idioma: español
- Tribunal Calificador de la Tesis: Harald Paganetti (presid.), Juan Diego Azcona Armendáriz (secret.), Yolanda Prezado Alonso (voc.)
- Programa de doctorado: Programa de Doctorado en Ciencias Naturales y Aplicadas por la Universidad de Navarra
- Materias:
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- Resumen
Radiotherapy (RT), particularly external beam radiotherapy (EBRT), is a key modality in cancer treatment. However, an ongoing challenge is the unintended irradiation of circulating blood, which can lead to hematologic toxicity and immune suppression. While modern RT techniques have improved dose conformity, the effects of radiation on the circulatory system remain a growing concern. Current blood dose estimation models often rely on simplified frameworks that do not account for patient-specific vascular structures and real-time blood flow dynamics, potentially leading to inaccuracies in predicting radiation-induced hematologic toxicities and their clinical consequences.
This thesis addresses these limitations by developing a comprehensive and patient-specific framework for blood dose quantification. The research is structured into three steps, each one an improvement of the previous one: first, establishing a simple proof-of-concept model to estimate blood dose in prostate cancer patients for photon RT treatments; second, developing the FLIP (FLow and Irradiation Personalized) method to improve the quantification of dose received by circulating blood in photon and proton RT treatments using patient-specific vasculature, blood flow velocity field, dynamic 3D dose distributions and real beam delivery measurements; and third, integrating FLIP into a global hemodynamic framework called HEDOS (HEmatological DOSe), yielding FLIP-HEDOS. This integration combines patient-specific data and standardized parameters, thereby enhancing its applicability. FLIP-HEDOS model enables a more precise assessment of venous and arterial circulation. Moreover, a comparative analysis is performed to evaluate the different tools developed to quantify dose to circulating blood.
A key contribution of this work is the integration of patient-specific blood vessel segmentation, blood flow velocity field modeling, dynamic real-time beam delivery, and blood element tracking, to improve the accuracy of blood dose quantification. This research is particularly relevant for both proton and photon RT modalities, where differences in dose delivery mechanisms significantly impact blood irradiation. Understanding these differences is essential for optimizing RT strategies to minimize unnecessary circulating blood exposure while maintaining effective tumor control.
