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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Main Author: Ruijie Meng
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Clinical and Translational Radiation Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405630825000965
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author Ruijie Meng
author_facet Ruijie Meng
author_sort Ruijie Meng
collection DOAJ
description 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.
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spelling doaj-art-34fb8056b04941569dcd9b8cff69ea182025-08-20T03:36:14ZengElsevierClinical and Translational Radiation Oncology2405-63082025-09-015410100410.1016/j.ctro.2025.101004Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguardsRuijie Meng0Address: Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an, Shaanxi Province 710061, PR China.; Department of Radiation Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, PR ChinaIn 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.http://www.sciencedirect.com/science/article/pii/S2405630825000965Pediatric TBIRenal toxicityRadiation tolerance predictionDose-rate effectsPrecision radiotherapy
spellingShingle Ruijie Meng
Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards
Clinical and Translational Radiation Oncology
Pediatric TBI
Renal toxicity
Radiation tolerance prediction
Dose-rate effects
Precision radiotherapy
title Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards
title_full Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards
title_fullStr Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards
title_full_unstemmed Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards
title_short Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards
title_sort optimizing predictive accuracy of the two component repair model for pediatric tbi pediatric specific parameters toxicity endpoint harmonization and dose rate safeguards
topic Pediatric TBI
Renal toxicity
Radiation tolerance prediction
Dose-rate effects
Precision radiotherapy
url http://www.sciencedirect.com/science/article/pii/S2405630825000965
work_keys_str_mv AT ruijiemeng optimizingpredictiveaccuracyofthetwocomponentrepairmodelforpediatrictbipediatricspecificparameterstoxicityendpointharmonizationanddoseratesafeguards