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normais e reirradiação
• Can be graded:
» RTOG / EORTC
» CTCAE v3
» WHO
• β Sub-lethal damage
• RE = relative effectiveness
• “α“
• linear component
• no or little repair
• less sensitive to fractionation
• “β”
• exponential component
• potential for repair
• more sensitive to fractionation
• “α/β“
• high: less potential for repair = less sensitive to
fractionation
• low: more potential for repair = more sensitive to
fractionation
Isabel Bravo – Jan 2011
α/β ratios
• Large α/β ratios • Small α/β ratio
• α/β = 10 to 20 • α/β = 2
– Early or acute – Late reacting
reacting tissues tissues, e.g. spinal
– Most tumours cord
– potentially prostate
cancer
Effect of fractionation
• fractionation
• sublethal damage repair
• single dose/hypofractionation
• no or minor repair
• Repair
• “fast”: 10-20 min
• “slow”: > 2 h
• intercellular repair: hours
– days
• “half-time” of repair: 2
hours
What do we want?
• calculate an isoeffective dose-fractionation
schedule
• predict normal tissue tolerance probability
(NTCP)
What do we need?
• the „endpoint“ (=side effect)