PMID: 8966232Feb 1, 1996Paper

Repair capacity and kinetics for human mucosa and epithelial tumors in the head and neck: clinical data on the effect of changing the time interval between multiple fractions per day in radiotherapy

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
S M BentzenH D Thames

Abstract

Early mucosal reactions are a major concern in radiotherapy of tumors in the head and neck. With some of the current strategies for altered fractionation these reactions may become dose limiting, and this has created a renewed interest in their radiobiology. The present paper reviews data on the response of mucosa in the head and neck to a change in dose per fraction (repair capacity) and time interval between dose fractions (repair kinetics). A review of clinical data on repair capacity shows that the alpha/beta ratio of the linear-quadratic model is high, around 10 Gy. Also, the steepness of the dose-response curve for mucositis is high as quantified by the maximum value of the normalized dose-response gradient, gamma 50 = 6.9 +/- 2.1. Computer simulations illustrate how this high value may be explained by the structural and proliferative organization of the mucosa. Finally, data from the following four recent studies are analyzed: the Radiation Therapy Oncology Group studies 7913 and 8313, a study from the M.D. Anderson Cancer Center, and a study from the Center of Oncology in Warsaw. All of these studies showed a decrease in the incidence of mucosal reactions when the interval between fractions given in the same day was inc...Continue Reading

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