Cellular proliferation is an integral part of the maintenance of the organism. While many tissues in the adult are essentially non-dividing, others, the socalled cell renewal systems, are in a constant state of division, maturation and loss, for example in skin and gut. The process of homeostasis keeps the balance between cell production and cell loss so that the cell proliferation rate is exactly balanced by cell loss. It is a fundamental part of the development of cancer that there is a loss of this homeostatic control such that cell production becomes uncontrolled, with cells proliferating faster than they are lost. It is now generally recognised that the rate of tumour cell proliferation can be a major factor in determining the success of treatment. This is certainly the case for the treatment of tumours by fractionated radiotherapy (Fowler 1986; Withers et al. 1988) and is expected to be true for chemotherapy when there are also intervals between treatments. In the case of radiotherapy, clinical trials are underway to assess strategies to overcome tumour cell proliferation during treatment by means of accelerated fractionation schedules when, in the extreme, the overall treatment time has been reduced to 12 days without a break, giving three fractions per day (Saunders et al. 1988). Of course, cell proliferation during treatment will not be a problem with all tumours. Many may be satisfactorily treated by conventional schedules. It would clearly be of considerable value, therefore, if those tumours for which cell proliferation may be a problem could be identified prior to treatment, allowing a rational selection of patients for accelerated treatment (Wilson et al. 1988).
Relative Movement Local Tumour Control Aneuploid Tumour Diploid Tumour Proliferation Parameter
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