DOSE FRACTIONATION AND TUMOR REPOPULATION IN RADIOTHERAPY FOR BLADDER-CANCER
DOSE FRACTIONATION AND TUMOR REPOPULATION IN RADIOTHERAPY FOR BLADDER-CANCER
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DOI：
10.1016/0167-8140(91)90033-d
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发表时间：
1991-07-01
影响因子：
5.7
通讯作者：
MAJEWSKI, S
中科院分区：
文献类型：
--
作者：
MACIEJEWSKI, B;MAJEWSKI, S
对77例膀胱移行细胞癌的局部控制进行了分析，分析了分数大小变化标准化后的总剂量和总治疗时间。 对于63.3戈伊的TCD 50，将总治疗时间从40天平均延长至55天，使局部控制率从50%降至约5%。 随着总体治疗时间的延长，局部肿瘤控制的降低可能反映了治疗期间肿瘤再增殖的加速。 为了确定加速肿瘤克隆原再增殖的开始时间，分析了从文献中获取的数据。 结果表明，平均而言，膀胱移行细胞癌中的肿瘤克隆原再增殖在治疗开始后约5-6周的滞后期后加速，并且需要每天0.36戈伊的剂量增量来补偿这种再增殖。 这样的剂量增量与约5-8天的克隆原倍增时间一致。 这表明总治疗时间是剂量分次的重要因素，延长时间可能对治疗结果产生显著影响。 因此，膀胱癌的放射治疗应尽快完成，因此，局部肿瘤控制概率高的总剂量应每周超过5次。
Local control of the 77 transitional cell carcinoma of the bladder was analysed with respect to total dose after normalization for variations in fraction size and to overall treatment time. For the TCD50 of 63.3 Gy protraction of overall treatment time from 40 to 55 days average gave the decrease in local control rate from 50% to about 5%. The decrease in local tumour control with extension of overall treatment time likely reflects accelerated tumour repopulation during the treatment. To determine the time onset of the accelerated tumour clonogen repopulation, data taken from the literature were analysed. Results show that on average tumour clonogen repopulation in transitional cell cancer of the bladder accelerates after a lag period of about 5-6 weeks after the start of treatment and that a dose increment of 0.36 Gy per day is required to compensate for this repopulation. Such a dose increment is consistent with about 5-8 day clonogen doubling time. It suggests that overall treatment time is an important factor in the dose fractionation and protraction of time may have a significant impact on treatment outcome. Thus, radiotherapy for bladder cancer should be completed as soon as possible and total dose for high probability of local tumour control should consequently be delivered in more than 5 fractions per week.