Document Detail


Alternate day treatment and late effects: the concept of an effective dose per fraction.
MedLine Citation:
PMID:  2254117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although most institutions treat all fields each day, some radiotherapists continue to adopt an alternate day schedule. The resulting daily variations of the dose per fraction in laterally located targets have been analyzed using the linear-quadratic model. Patients with breast carcinoma treated with definitive radiotherapy in 1974-1975 with one field a day were studied. An effective dose per fraction was derived, with a value higher than the average dose per fraction received by the reference point. The greater the fluctuations between the doses per fraction on successive days, the higher the effective dose per fraction. The corresponding cell survival due to alternate treatment as compared to survival with daily treatment depends on the alpha/beta ratio. For a late effect with low alpha/beta ratio, an alternate treatment may lead to almost 10-fold increase in cell kill in these lateral targets such as those responsible for subcutaneous sclerosis as compared to daily treatment of all fields with the same total dose. Taking the average effective dose per fraction in our series, the increase in cell kill was 4-fold. Acute effects would suffer less damage due to alternate treatment because of a high alpha/beta ratio. Treatment on an alternate schedule should be restricted to palliative radiotherapy.
Authors:
A Courdi; M Héry; J M Gabillat
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  19     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1991-01-18     Completed Date:  1991-01-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1225-8     Citation Subset:  IM    
Affiliation:
Centre A. Lacassagne, Nice, France.
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MeSH Terms
Descriptor/Qualifier:
Breast Neoplasms / epidemiology,  radiotherapy*
Cell Survival / radiation effects
Female
France / epidemiology
Humans
Linear Models
Radiotherapy Dosage*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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