Radiobiological basis of SBRT and SRS
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- 作者：Chang W. Song (1)
Mi-Sook Kim (2)
L. Chinsoo Cho (1)
Kathryn Dusenbery (1)
Paul W. Sperduto (1) - 关键词：SBRT/SRS ; Radiobiology ; Vascular damage
- 刊名：International Journal of Clinical Oncology
- 出版年：2014
- 出版时间：August 2014
- 年：2014
- 卷：19
- 期：4
- 页码：570-578
- 全文大小：654 KB
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Mi-Sook Kim (2)
L. Chinsoo Cho (1)
Kathryn Dusenbery (1)
Paul W. Sperduto (1)
1. Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota Medical School, K119 Diehl Hall, 424 Harvard Street S.E., MMC 494, Minneapolis, MN, 55455, USA
2. Department of Radiation Oncology, Korea Institute of Radiological and Medical Science, Seoul, Korea - ISSN：1437-7772
文摘
Stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) have been demonstrated to be highly effective for a variety of tumors. However, the radiobiological principles of SBRT and SRS have not yet been clearly defined. It is well known that newly formed tumor blood vessels are fragile and extremely sensitive to ionizing radiation. Various lines of evidence indicate that irradiation of tumors with high dose per fraction, i.e. >10?Gy per fraction, not only kills tumor cells but also causes significant damage in tumor vasculatures. Such vascular damage and ensuing deterioration of the intratumor environment then cause ischemic or indirect/secondary tumor cell death within a few days after radiation exposure, indicating that vascular damage plays an important role in the response of tumors to SBRT and SRS. Indications are that the extensive tumor cell death due to the direct effect of radiation on tumor cells and the secondary effect through vascular damage may lead to massive release of tumor-associated antigens and various pro-inflammatory cytokines, thereby triggering an anti-tumor immune response. However, the precise role of immune assault on tumor cells in SBRT and SRS has not yet been clearly defined. The - Rs-for conventional fractionated radiotherapy do not include indirect cell death and thus 4 Rs cannot account for the effective tumor control by SBRT and SRS. The linear-quadratic model is for cell death caused by DNA breaks and thus the usefulness of this model for ablative high-dose SBRT and SRS is limited.