Hypofractionation results in reduced tumor cell kill compared to conventional fractionation for tumors with regions of hypoxia.

Purpose: Tumor hypoxia has been observed in many human cancers and is associated with treatment failure in radiation therapy. The purpose of this study is to quantify the effect of different radiation fractionation schemes on tumor cell killing, assuming a realistic distribution of tumor oxygenation...

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Publicado en:International Journal of Radiation Oncology, Biology, Physics Vol. 79; no. 4; pp. 1188 - 1196
Autores principales: Carlson DJ, Keall PJ, Loo BW Jr, Chen ZJ, Brown JM, Carlson, David J, Keall, Paul J, Loo, Billy W Jr, Chen, Zhe J, Brown, J Martin
Formato: research Journal Article
Publicado: Pergamon Press - An Imprint of Elsevier Science Mar2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2011
      vid: 79
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        10.1016/j.ijrobp.2010.10.007
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        atl: Hypofractionation results in reduced tumor cell kill compared to conventional fractionation for tumors with regions of hypoxia.
      aug:
        au:
          Carlson DJ
          Keall PJ
          Loo BW Jr
          Chen ZJ
          Brown JM
          Carlson, David J
          Keall, Paul J
          Loo, Billy W Jr
          Chen, Zhe J
          Brown, J Martin
        affil: Stanford University School of Medicine, Department of Radiation Oncology, Stanford, CA, USA
      sug:
        subj:
          Cell Physiology Radiation Effects
          Radiation Dosage
          Oxygen Consumption Physiology
          Radiation
          Algorithms
          Capillaries Anatomy and Histology
          Capillaries Metabolism
          Cell Physiology Drug Effects
          Head and Neck Neoplasms Metabolism
          Head and Neck Neoplasms Radiotherapy
          Human
          Linear Regression
          Male
          Imidazoles Pharmacodynamics
          Partial Pressure
          Prostatic Neoplasms Metabolism
          Prostatic Neoplasms Radiotherapy
          Radiation-Sensitizing Agents Pharmacodynamics
          Treatment Failure
          Male
      ab: Purpose: Tumor hypoxia has been observed in many human cancers and is associated with treatment failure in radiation therapy. The purpose of this study is to quantify the effect of different radiation fractionation schemes on tumor cell killing, assuming a realistic distribution of tumor oxygenation.Methods and Materials: A probability density function for the partial pressure of oxygen in a tumor cell population is quantified as a function of radial distance from the capillary wall. Corresponding hypoxia reduction factors for cell killing are determined. The surviving fraction of a tumor consisting of maximally resistant cells, cells at intermediate levels of hypoxia, and normoxic cells is calculated as a function of dose per fraction for an equivalent tumor biological effective dose under normoxic conditions.Results: Increasing hypoxia as a function of distance from blood vessels results in a decrease in tumor cell killing for a typical radiotherapy fractionation scheme by a factor of 10(5) over a distance of 130 μm. For head-and-neck cancer and prostate cancer, the fraction of tumor clonogens killed over a full treatment course decreases by up to a factor of ∼10(3) as the dose per fraction is increased from 2 to 24 Gy and from 2 to 18 Gy, respectively.Conclusions: Hypofractionation of a radiotherapy regimen can result in a significant decrease in tumor cell killing compared to standard fractionation as a result of tumor hypoxia. There is a potential for large errors when calculating alternate fractionations using formalisms that do not account for tumor hypoxia.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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