Hypofractionation for radiotherapy of prostate cancer using a low alfa/beta ratio--possible reasons for concerns? An example of five dimensional radiotherapy

Acta Oncologica
B LennernäsSeymour Levitt


It is very attractive, due to the assumed low alfa/beta ratio of prostate cancer (PC), to construct new treatment schedules for prostate cancer using only a few large fractions of radiation (hypofractionation). This will widen the therapeutic window since the ratio for PC might be lower than that of the organs at risk (OAR). PC is an extremely variable disease and often contains both highly and poorly differentiated cells. It is reasonable to assume that different cells have different patterns of radiosensitivity, i.e. alfa/beta ratios and proliferation. In this study we will simulate the effect on the outcome of the treatment with different fractionations and different ratios. In this simulation we use an extension of the Linear Quadratic (LQ)/Biological Effective Dose (BED) formula called the dose volume inhomogeneity corrected BED (DVIC-BED). In the formula the tumour volume is divided in 50 subvolumes (step of 2%) and it is possible to calculate the relative effect of the treatment with different ratios (1.5, 4 and 6.5) in different subvolumes. The simulations demonstrate that only a small portion (5-10%) of cells with a higher ratio will dramatically change the effect of the treatment. Increasing the total dose can compens...Continue Reading


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Prostatic Neoplasms
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