liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Optimal fractionation in radiotherapy for non-small cell lung cancer - a modelling approach
Stockholm University.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics.ORCID iD: 0000-0001-8171-2541
Stockholm University and Karolinska Institutet.ORCID iD: 0000-0002-7101-240X
2015 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 54, no 9, 1592-1598 p.Article in journal (Refereed) Published
Abstract [en]

Background. Conventionally fractionated radiotherapy (CFRT) has proven ineffective in treating non-small cell lung cancer while more promising results have been obtained with stereotactic body radiotherapy (SBRT). Hypoxic tumours, however, might present a challenge to extremely hypofractionated schedules due to the decreased possibility for inter-fraction fast reoxygenation. A potentially successful compromise might be found in schedules employing several fractions of varying fractional doses. In this modelling study, a wide range of fractionation schedules from single-fraction treatments to heterogeneous, multifraction schedules taking into account repair, repopulation, reoxygenation and radiosensitivity of the tumour cells, has been explored with respect to the probability of controlling lung tumours.

Material and methods. The response to radiation of tumours with heterogeneous spatial and temporal oxygenation was simulated including the effects of accelerated repopulation and intra-fraction repair. Various treatments with respect to time, dose and fractionation were considered and the outcome was estimated as Poisson-based tumour control probability for local control.

Results. For well oxygenated tumours, heterogeneous fractionation could increase local control while hypoxic tumours are not efficiently targeted by such treatments despite reoxygenation. For hypofractionated treatments employing large doses per fraction, a synergistic effect was observed between intra-fraction repair and inter-fraction fast reoxygenation of the hypoxic cells as demonstrated by a reduction in D50 from 53.3 Gy for 2 fractions to 52.7 Gy for 5 fractions.

Conclusions. For well oxygenated tumours, heterogeneous fractionation schedules could increase local control rates substantially compared to CFRT. For hypoxic tumours, SBRT-like hypofractionated schedules might be optimal despite the increased risk of intra-fraction repair due to a synergistic effect with inter-fraction reoxygenation.

Place, publisher, year, edition, pages
2015. Vol. 54, no 9, 1592-1598 p.
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-120307DOI: 10.3109/0284186X.2015.1061207ISI: 000366674700049PubMedID: 26217986OAI: oai:DiVA.org:liu-120307DiVA: diva2:843386
Available from: 2015-07-28 Created: 2015-07-28 Last updated: 2016-01-11

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedOpen Access PDF

Search in DiVA

By author/editor
Dasu, AlexandruToma-Dasu, Iuliana
By organisation
Division of Radiological SciencesFaculty of Medicine and Health SciencesDepartment of Radiation Physics
In the same journal
Acta Oncologica
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 317 hits
ReferencesLink to record
Permanent link

Direct link