Extreme hypofractionation for prostate cancer.
In ideal circumstances the fractionation schedule of radiotherapy should match the fractionation sensitivity of the tumor relative to the nearby normal tissues. A number of recent publications have suggested that the alpha/beta ratio for prostate tumors is low - in the range of 1-3 Gy. In fact, if alpha/beta is low, then hypofractionated schedules using fewer, larger fractions should improve the therapeutic ratio. This critical article examines two methods that represent schedules at the extreme end of the fractionation spectrum (3-5 fractions): high-dose-rate brachytherapy as monotherapy and stereotactic body radiotherapy.
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