Dose-rate effects in external beam radiotherapy redux Journal Article
| Authors: | Ling, C. C.; Gerweck, L. E.; Zaider, M.; Yorke, E. |
| Article Title: | Dose-rate effects in external beam radiotherapy redux |
| Abstract: | Recent developments in external beam radiotherapy, both in technical advances and in clinical approaches, have prompted renewed discussions on the potential influence of dose-rate on radio-response in certain treatment scenarios. We consider the multiple factors that influence the dose-rate effect, e.g. radical recombination, the kinetics of sublethal damage repair for tumors and normal tissues, the difference in α/β ratio for early and late reacting tissues, and perform a comprehensive literature review. Based on radiobiological considerations and the linear-quadratic (LQ) model we estimate the influence of overall treatment time on radio-response for specific clinical situations. As the influence of dose-rate applies to both the tumor and normal tissues, in oligo-fractionated treatment using large doses per fraction, the influence of delivery prolongation is likely important, with late reacting normal tissues being generally more sensitive to the dose-rate effect than tumors and early reacting tissues. In conventional fractionated treatment using 1.8-2 Gy per fraction and treatment times of 2-10 min, the influence of dose-rate is relatively small. Lastly, the dose-rate effect in external beam radiotherapy is governed by the overall beam-on-time, not by the average linac dose-rate, nor by the instantaneous dose-rate within individual linac pulses which could be as high as 3 × 10 6 MU/min. © 2010 Elsevier Ireland Ltd. All rights reserved. |
| Keywords: | review; intensity modulated radiation therapy; nonhuman; cancer radiotherapy; radiation dose; neoplasms; animals; dna damage; cell survival; dna repair; radiotherapy dosage; mathematical model; dosimetry; radiation dose fractionation; tumor cell; external beam radiotherapy; chromosome aberrations; stereotactic body radiation therapy; cell killing; radiobiology; dose-rate effect |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 95 |
| Issue: | 3 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-06-01 |
| Start Page: | 261 |
| End Page: | 268 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2010.03.014 |
| PUBMED: | 20363041 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 9" - "Export Date: 25 June 2012" - "CODEN: RAOND" - "Source: Scopus" |
Altmetric
Citation Impact
Related MSK Work