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      Optimal unified combination rule in application of Dempster‐Shafer theory to lung cancer radiotherapy dose response outcome analysis

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          Abstract

          Our previous study demonstrated the application of the Dempster‐Shafer theory of evidence to dose/volume/outcome data analysis. Specifically, it provided Yager's rule to fuse data from different institutions pertaining to radiotherapy pneumonitis versus mean lung dose. The present work is a follow‐on study that employs the optimal unified combination rule, which optimizes data similarity among independent sources. Specifically, we construct belief and plausibility functions on the lung cancer radiotherapy dose outcome datasets, and then apply the optimal unified combination rule to obtain combined belief and plausibility, which bound the probabilities of pneumonitis incidence. To estimate the incidence of pneumonitis at any value of mean lung dose, we use the Lyman‐Kutcher‐Burman (LKB) model to fit the combined belief and plausibility curves. The results show that the optimal unified combination rule yields a narrower uncertainty range (as represented by the belief–plausibility range) than Yager's rule, which is also theoretically proven.

          PACS numbers: 87.55.dh, 87.55.dk

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          Most cited references10

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          Use of normal tissue complication probability models in the clinic.

          The Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) review summarizes the currently available three-dimensional dose/volume/outcome data to update and refine the normal tissue dose/volume tolerance guidelines provided by the classic Emami et al. paper published in 1991. A "clinician's view" on using the QUANTEC information in a responsible manner is presented along with a description of the most commonly used normal tissue complication probability (NTCP) models. A summary of organ-specific dose/volume/outcome data, based on the QUANTEC reviews, is included. Copyright 2010 Elsevier Inc. All rights reserved.
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            Radiation dose-volume effects in the lung.

            The three-dimensional dose, volume, and outcome data for lung are reviewed in detail. The rate of symptomatic pneumonitis is related to many dosimetric parameters, and there are no evident threshold "tolerance dose-volume" levels. There are strong volume and fractionation effects. Copyright 2010 Elsevier Inc. All rights reserved.
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              Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues.

              Advances in dose-volume/outcome (or normal tissue complication probability, NTCP) modeling since the seminal Emami paper from 1991 are reviewed. There has been some progress with an increasing number of studies on large patient samples with three-dimensional dosimetry. Nevertheless, NTCP models are not ideal. Issues related to the grading of side effects, selection of appropriate statistical methods, testing of internal and external model validity, and quantification of predictive power and statistical uncertainty, all limit the usefulness of much of the published literature. Synthesis (meta-analysis) of data from multiple studies is often impossible because of suboptimal primary analysis, insufficient reporting and variations in the models and predictors analyzed. Clinical limitations to the current knowledge base include the need for more data on the effect of patient-related cofactors, interactions between dose distribution and cytotoxic or molecular targeted agents, and the effect of dose fractions and overall treatment time in relation to nonuniform dose distributions. Research priorities for the next 5-10 years are proposed. Copyright 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                physhery@gmail.com
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                08 January 2016
                January 2016
                : 17
                : 1 ( doiID: 10.1002/acm2.2016.17.issue-1 )
                : 4-11
                Affiliations
                [ 1 ] Scientific Computing and Imaging Institute, University of Utah Salt Lake City UT
                [ 2 ] Mathematics, Florida State University Tallahassee FL
                [ 3 ] Radiation Oncology, Thomas Jefferson University Philadelphia PA USA
                Author notes
                [*] [* ] aCorresponding author: Yutao U. T. Gong, Radiation Oncology, Thomas Jefferson University, 111 South 11th St., G‐319, Philadelphia, PA 19107, USA; phone: (215) 955 1185; fax: (215) 955 0412; email: physhery@ 123456gmail.com

                Article
                ACM20004
                10.1120/jacmp.v17i1.5737
                5690231
                26894343
                473ccdc8-d685-413b-8f79-36485f9256b9
                © 2016 The Authors.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 April 2015
                : 10 September 2015
                Page count
                Figures: 2, Tables: 3, References: 10, Pages: 8, Words: 3297
                Categories
                Review Articles
                Review Articles
                Custom metadata
                2.0
                acm20004
                January 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.3 mode:remove_FC converted:28.03.2018

                dempster‐shafer theory,evidence theory,belief and plausibility measures,dose‐volume effects,quantitative analyses of normal tissue effects in the clinic (quantec)

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