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Radiobiology of Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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Technical Basis of Radiation Therapy

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

In recent years, increasing number of cancer patients are treated with stereotactic radiosurgery (SRS) or stereotactic body radiation therapy (SBRT), which deliver hypofractionated irradiation with high-dose per fraction . It is highly likely that the radiobiological principles such as 4 Rs (Reoxygenation, Repair, Redistribution, Repopulation) for the conventional fractionated radiotherapy with small-dose per fractions do not apply for SRS and SBRT. Reoxygenation: When tumors are exposed to high-dose per fraction, e.g. >10 Gy, significant vascular damage will occur. Consequently, intratumor environment becomes hypoxic and acidic, which not only will prevent reoxygenation of hypoxic cells but also will cause indirect cell death. Repair: delivery of SRS or SBRT lasts considerable lengths of time, which may allow repair of sub-lethal radiation damage during the irradiation exposure. Redistribution: high-dose irradiation prevents cell cycle progression and cells undergo interphase death in the cell cycle phases where they are irradiated. Repopulation: Since SRS or SBRT treatment is completed within 1-2 weeks, repopulation of tumor cells during the course of treatment may be negligible. The linear-quadratic (LQ) model , which is used to calculate isoeffect doses for different hyperfractionated irradiation schemes, may be applied for hypofractionated SRS or SBRT, provided that indirect cell death due to vascular damage is negligible.

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Authors and Affiliations

  1. Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota, 420 Delaware St. SE, Mayo Mail Code 494, Minneapolis, MN, 55455, USA

    Chang W. Song, Heonjoo Park, Robert J. Griffin & Seymour H. Levitt

  2. Inha university, Inchon, Korea

    Heonjoo Park

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  1. Chang W. Song
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  2. Heonjoo Park
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  3. Robert J. Griffin
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  4. Seymour H. Levitt
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Correspondence to Chang W. Song .

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Editors and Affiliations

  1. Institutet Stockholm Sweden, MMC 436, Dept.of Oncol-Pathol Karolinska, Delaware St. SE 420, Minneapolis, 55455, Minnesota, USA

    Seymour H. Levitt

  2. UC Davis Cancer Center, Dept. Radiation Oncology, University of California, Davis, X Street 4501, Sacramento, 95817, California, USA

    James A. Purdy

  3. School of Medicine, Dept. Radiation Oncology, Washington University, Forest Park Ave. 4511, St. Louis, 63108-2138, Michigan, USA

    Carlos A. Perez

  4. Instituut Verbeeten, Tilburg, 5042 SB, Netherlands

    Philip Poortmans

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Song, C.W., Park, H., Griffin, R.J., Levitt, S.H. (2011). Radiobiology of Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. In: Levitt, S., Purdy, J., Perez, C., Poortmans, P. (eds) Technical Basis of Radiation Therapy. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_264

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