Radiobio EQD2 Questions: 2020

Question 1
An 80yr old man presents with a SCC of the parotid gland. He is not suitable for
chemo-radiation and it is decided he will receive 50Gy in 15 fractions, as a
palliative treatment . What is the EQD2 for:
a) Tumour control using 
b) Late fibrosis using of 3.

Question 2
Patient received 50Gy in 20# for a lung cancer. His spinal cord received 90% of
the total dose.
He now presents with a recurrence within the field. What, if any, further dose can
be given to the cord?
Max cord dose 50Gy in 2 Gy #
a/b – 1.8

Question 3
Melanoma patient is to receive 48Gy/20#. If the brachial plexus dose is to receive
45Gy/20# max,
A) What is the EQD2 for the brachial plexus?
a/b 1.8
B) The plan does not restrict the dose to the brachial plexus and the maximum is
120% what is the EQD2 to the plexus?
C) Will you accept this brachial plexus dose?

Question 4 :
A 75 yr old with a brain tumour close to the optic chiasm is not suitable for
radical treatment and it is decided to offer him a hypofractionated course of
40Gy in 15# . The optic chiasm receives 100% of the dose , what is the EQD2
using an of 2. If the plan is changed and the chiasm now gets 120% of
the dose what is the EQD2 using an of 2?

Question 5:
Your centre currently treats prostate cancer with 74Gy in 32#, 5 days a week. You are
planning to change to a hypofractionated course of 66Gy at 3Gy per fraction.
A) What is the expected impact on tumour control compared to your reference
dose?
B) Assuming the clinically relevant rectal dose is 90% of the prescribed dose,
What is the expected impact on late rectal side effects compared to your reference
rectal dose
a/b = 3 for prostate cancer
a/b = 4.0 for late bowel damage,

If you were to change to an external beam dose of 45Gy in 25# and a brachytherapy
boost of 2 fractions of 9.5 Gy,
How does this change your tumour control and rectal toxicity. For the purpose of this
exercise use a rectal dose at 90%.
E/ = D[1+d/()]

EQD2 = D (d + )/ (2 + )

EQD2 = D (dg + )/ (2 + )

g = 1 for HDR

D = P-E
d = [Pp – Ee]/P-E