Reply to Comments on 'Modeling for predicting survival fraction of cells after ultra-high dose rate irradiation'.

Liew and Mairani (2024 Phys. Med. Biol . 69 248001) commented on our previous reply to comments on our paper, 'Modeling for predicting survival fraction of cells after ultra-high dose rate irradiation'. We appreciate their comments on the choice of experimental data on DNA damage for cell survival and agree that the estimate of the dose-response curve on cell survival depends on the selection of DNA damage data. As an additional benchmark test, we compared the relative biological effectiveness (RBE) predicted using the recommended DNA damage data measured in normoxia with those reported in our original paper, and confirmed that the difference in RBE was less than 8%. Although our model allows for the estimation of cell survival and RBE under ultra-high dose rate (UHDR) irradiation, we highlight that a further accumulation of experimental data on DNA damage under UHDR irradiation is necessary for the further development of biophysical models concerning the mechanistical estimation of biological effects.
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