Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards

In response to the innovative two-component repair model for pediatric TBI renal toxicity prediction, this letter proposes three key refinements to enhance clinical translation: adopting pediatric-specific radiobiological parameters (e.g., DNA-PKcs dynamics, α/β ratios) to address systematic overest...

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Bibliographic Details
Main Author: Ruijie Meng
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405630825000965
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Summary:In response to the innovative two-component repair model for pediatric TBI renal toxicity prediction, this letter proposes three key refinements to enhance clinical translation: adopting pediatric-specific radiobiological parameters (e.g., DNA-PKcs dynamics, α/β ratios) to address systematic overestimation of radiation tolerance; harmonizing toxicity endpoints to CTCAE v5.0 ≥Grade 3 criteria to strengthen doseresponse associations and enable precise risk stratification; and implementing institution-specific minimum dose-rate thresholds to mitigate unmodeled vascular susceptibility during low-dose-rate TBI. Collectively, these optimizations will improve predictive accuracy and support personalized radiotherapy for high-risk pediatric cohorts.
ISSN:2405-6308