The volume-effect in Radiotherapy: Stereotactic Radiotherapy Chiara De Colle University of Turin Outline • Rationale and concept of SBRT • Normal tissue effects o experimental data o clinical data • Tumour effects o experimental data o clinical data • Is there a new radiobiology?
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The volume-effect in Radiotherapy: Stereotactic RadiotherapyThe volume-effect in Radiotherapy: Stereotactic Radiotherapy Chiara De Colle University of Turin Outline •Rationale and
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The volume-effect in Radiotherapy:
Stereotactic Radiotherapy
Chiara De Colle
University of Turin
Outline
• Rationale and concept of SBRT
• Normal tissue effectso experimental datao clinical data
• Tumour effectso experimental datao clinical data
• Is there a new radiobiology?
Therapeutic window – aim of RT
Adapted by Holthusen, Strahlentherapie 57: 254-268,1936
Balance between local tumour control and side effects
Hanahan and Weinberg, Cell 2000, 100:57-70
H. Thames et al., IJROBP 1982
Effects of dose/fraction alteration
M. Joiner & A. van der Kogel, Basic
Clinical Radiobiology, 4th ed. Arnold 2009
α/β late responding tissue (e.g spinal chord)≈ 3α/β early responding tissue (e.g skin)≈ 10
Feasibility of SBRT:Technological advances
Withers et al, 1988
Functional Sub Unit (FSU): the largest tissue volume that can be regenerated from a single surviving clonogenic cell