1: Acta Oncol. 1988;27(2):117-22.
Related Articles, Links
Spontaneous radiation-induced rib fractures in breast
cancer patients treated with postmastectomy irradiation. A
clinical radiobiological analysis of the influence of fraction
size and dose-response relationships on late bone
damage.
Overgaard M.
Department of Oncology and Radiotherapy, Radiumstationen, Aarhus, Denmark.
The influence of fraction size on normal tissue damage was analysed in 231 patients
treated with postmastectomy irradiation given either with a 12-fraction regimen (19781980) or with a 22-fraction regimen (1981). Chest radiographs taken 1-6 years after
treatment were reviewed for spontaneous, radiation-induced rib fracture within the
treated area. Patients treated with a large dose per fraction had significantly higher
incidence of late bone damage (19%) than patients treated with a standard dose per
fraction (6%) even though they had been treated with the aim to obtain equivalent
biologic response according to the NSD formula. Furthermore, there was a clear
dose-response relationship, especially in the 12-fraction regimen, where the total
dose at the reference point varied over a wide range. Isoeffect doses could be
estimated for the two different fractionation schedules. Using the linear quadratic
model, alpha/beta ratios for late bone damage were estimated to be within the range
of 1.8-2.8 Gy, i.e. similar to those reported for other late responding normal tissues.
PMID: 3390342 [PubMed - indexed for MEDLINE]
1: Int J Radiat Oncol Biol Phys. 1984 May;10(5):599-606.
Related Articles, Links
The influence of fraction size in radiotherapy on the late
normal tissue reaction--II: Comparison of the effects of
daily and twice-a-week fractionation on human skin.
Turesson I, Notter G.
A comparison of the normal tissue reactions to daily and twice-a-week fractionation
over 4 to 6 weeks was performed on postoperatively irradiated parasternal fields in
patients with breast cancer. The radiation used was electron beams at 12-13 MeV.
We have previously reported that the overall treatment time was of importance for
establishment of iso-effect relationships for the acute skin erythema. In this paper we
present the degree of telangiectasia after 5 years. Generally, a more pronounced late
reaction was found after twice-a-week fractionation than was predicted from the acute
reactions. The findings imply that the cumulative radiation effect (CRE) formula has to
be modified for both acute and late reactions in certain clinical situations. The main
conclusion is that the iso-effect relationship varies significantly over the dose range
used in clinical radiotherapy. In the dose range of 30 fractions between 1.6 and 2.1
Gy in 6 weeks, the slope of the curve for iso-effect dose versus number of fractions
varies between 0.26 and 0.35, the beta/alpha-ratios between 0.22 and 0.37 Gy-1 and
the RBE 2 Fractions/week/5 Fractions/week between 1.97 and 1.82.
Publication Types:
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Clinical Trial
Controlled Clinical Trial
PMID: 6429092 [PubMed - indexed for MEDLINE]
1: Br J Radiol. 1984 Apr;57(676):309-16.
Related Articles, Links
The Cancer Research Campaign (King's/Cambridge) trial
for early breast cancer: an analysis of the radiotherapy
data.
Brinkley D, Haybittle JL, Houghton J.
A detailed study has been made of the patients receiving routine post-operative
radiotherapy in the Cancer Research Campaign trial for early breast cancer.
Particular attention has been paid to the routine dose delivered and the incidence of
recurrence in different areas. Little difference was apparent in the incidence of local
recurrence in groups of patients receiving different levels of dosage, although there
was a threefold reduction in five-year local recurrence-free rates compared with that
for patients who received no irradiation. Moderate or severe telangiectasis occurred
more frequently as the dose increased. When analysed in terms of survival, there
was a tendency for the patients receiving more than 1510 ret to do a little better, but
this was not statistically significant and could be due to some unexplained patient
selection or higher dosage. There was no suggestion that irradiation might cause
reduced survival.
Publication Types:


Clinical Trial
Controlled Clinical Trial
PMID: 6367882 [PubMed - indexed for MEDLINE]