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. Author manuscript; available in PMC: 2021 Dec 2.
Published in final edited form as: Nat Rev Phys. 2021 Sep 17;3(12):777–790. doi: 10.1038/s42254-021-00368-5

Figure 6. The ‘best’ bullets are those providing the lowest relative biological effectiveness-weighted dose in the normal tissue at the same effect in the target.

Figure 6

Relative biological effectiveness (RBE)-weighted dose optimization for a two-opposite-field treatment of an idealized geometry simulating a typical case of radiosensitive (part a) or radioresistant (part b) tumour. The tumour (2.5 × 2.5 × 2.5 cm3) is centred in the planning target volume. Biological dose optimization was performed using the TRiP98 software and the local effect model (LEM-IV)95. The plan was optimized with different ions to provide the same RBE-weighted dose of 2 Gy in the target volume. Protons are excellent for radiosensitive tumours but the worst for radioresistant tumours. Figure modified from Tommasino et al.167, distributed under Creative Commons CC-BY. Figure is adapted from REF.167, CC BY 4.0.