Modeling clinical outcomes in radiotherapy: NTCP, TCP and the “TECs”

Radiation therapy is a double-edged sword which damages both tumor and normal cells. Achieving treatments with high tumor control probability (TCP) yet low normal tissue complication probability (NTCP) is often a struggle because we rarely have a unified understanding of the dosimetric and clinical correlates of the desired outcomes. I am fortunate to have participated in some of these struggles, including analyzing and using in-house data and being involved in the AAPM and ASTRO "TEC" projects-QUANTEC (Quantitatie Analysis of Normal Tissue Effects in the Clinic), HyTEC (Hypofractionated Treatment Effects in the Clinic) and PENTEC (Pediatric Normal Tissue Effects in the Clinic).