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Radiobiological rationale for Stereotactic Hypofractionated Radiosurgery (SHRS) Part I. LQED2 or BED formalism
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Abstract
In conventional radiotherapy, 5R’s mechanisms influence tumour cell kill, but in SHRS they do not sufficiently explain the biology of large doses. Indirect cell death is also induced by endothelial damage, stem cell death and antitumour immunity are also activated by a single dose ≥ 12–15 Gy. These three processes defined as extra 3R’s are characterizers in details. Despite some controversies, LQED formalism seems not quite adequate for SHRS. Experimental and a few clinical studies suggest BED formalism as much more useful. Both formalisms are compared and discussed. Clinical reports show a monotonical increase in Tumour Cure Probability (TCP) with higher BED doses. The advantage of SHRS results in significant shortening overall treatment time and in delivery of the BED doses higher than 100 Gy, producing an increase in the TCP, likely unachievable by conventional dose fractionation.
Abstract
In conventional radiotherapy, 5R’s mechanisms influence tumour cell kill, but in SHRS they do not sufficiently explain the biology of large doses. Indirect cell death is also induced by endothelial damage, stem cell death and antitumour immunity are also activated by a single dose ≥ 12–15 Gy. These three processes defined as extra 3R’s are characterizers in details. Despite some controversies, LQED formalism seems not quite adequate for SHRS. Experimental and a few clinical studies suggest BED formalism as much more useful. Both formalisms are compared and discussed. Clinical reports show a monotonical increase in Tumour Cure Probability (TCP) with higher BED doses. The advantage of SHRS results in significant shortening overall treatment time and in delivery of the BED doses higher than 100 Gy, producing an increase in the TCP, likely unachievable by conventional dose fractionation.
Keywords
SHRS radiobiology, indirect extra 3R’s, BED in favour of LQED
Title
Radiobiological rationale for Stereotactic Hypofractionated Radiosurgery (SHRS) Part I. LQED2 or BED formalism
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
8-14
Published online
2018-06-20
Page views
937
Article views/downloads
878
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2018;68(1):8-14.
Keywords
SHRS radiobiology
indirect extra 3R’s
BED in favour of LQED
Authors
Bogusław Maciejewski
Sławomir Blamek
Krzysztof Składowski
Rafał Suwiński
Leszek Miszczyk
Krzysztof Ślosarek
Marcin Miszczyk