CELL LOSS FACTORS AND THE LINEAR-QUADRATIC MODEL

A method is described for incorporating a variable cell loss factor (phi) within the linear-quadratic (LQ) model. By allowing for a progressive reduction in phi as treatment progresses, the revised model behaves in a way which is consistent with the apparent presence of accelerated tumour repopulation during fractionated radiotherapy. Predictions based on a slowing of the cell loss process, rather than a true increase in clonogen proliferation rate, are consistent with the phenomenon of 'unmasking' of potential doubling time described by Fowler (Fowler, J.F. Rapid repopulation in radiotherapy: a debate on mechanism. Radiother Oncol 24: 125, 1992). An optional time delay factor may be included, to allow for the fact that progressive reduction in cell loss may not begin until part of the treatment has been delivered. The model provides a description of the manner in which tumour control doses are likely to increase as overall treatment time is increased.