PULSED BRACHYTHERAPY - THE CONDITIONS FOR NO SIGNIFICANT LOSS OF THERAPEUTIC RATIO COMPARED WITH TRADITIONAL LOW-DOSE RATE BRACHYTHERAPY

被引:78
作者
FOWLER, J
MOUNT, M
机构
[1] UNIV WISCONSIN,SCH MED,DEPT HUMAN ONCOL,MADISON,WI 53792
[2] UNIV WISCONSIN,SCH MED,DEPT MED PHYS,MADISON,WI 53792
[3] NUCLETRON CORP,COLUMBIA,MD 21045
[4] UNIV MIAMI,DEPT PHYS,CORAL GABLES,FL 33124
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1992年 / 23卷 / 03期
关键词
BRACHYTHERAPY; INTERMITTENT; PULSED; LINEAR-QUADRATIC MODEL; LOW DOSE-RATE; MULTIPLE FRACTIONS;
D O I
10.1016/0360-3016(92)90026-E
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Pulsed brachytherapy consists of using a stronger radiation source than for traditional low dose-rate brachytherapy, but giving a series of short exposures of 10 to 30 min in every hour, to approximately the same total dose in the same overall time as with the low dose-rate. Calculations based on the linear quadratic model, in which the beta x dose squared component only is assumed to be repairable, and at a monoexponential rate, show that there is no significant loss of therapeutic ratio, defined as tumor damage for a given level of late damage. Some loss of therapeutic ratio would in principle be expected when dose rates are increased, but, in the presently proposed applications, there are so many small pulses (fractions at medium or low dose-rate) that even though repair is not usually complete between them, the relative increase of late damage (in units proportional to log cell kill) is less than 10% more than the increase of tumor damage, except in unlikely conditions that we define. Although these calculations suggest that pulsed brachytherapy should be safe for pulse repetition frequencies up to about 2 hr, using dose rates not exceeding about 3 Gy/hr, we discuss the radiobiological reservations and the limitations of such calculations.
引用
收藏
页码:661 / 669
页数:9
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