How Low Can You Go? The Radiobiology of Hypofractionation

D H Brand; A M Kirby; J R Yarnold; N Somaiah

doi:10.1016/j.clon.2022.02.009

How Low Can You Go? The Radiobiology of Hypofractionation

Clin Oncol (R Coll Radiol). 2022 May;34(5):280-287. doi: 10.1016/j.clon.2022.02.009. Epub 2022 Mar 5.

Authors

D H Brand¹, A M Kirby², J R Yarnold², N Somaiah³

Affiliations

¹ The Institute of Cancer Research, London, UK.
² The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
³ The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK. Electronic address: Navita.Somaiah@icr.ac.uk.

PMID: 35260319
DOI: 10.1016/j.clon.2022.02.009

Abstract

Hypofractionated radical radiotherapy is now an accepted standard of care for tumour sites such as prostate and breast cancer. Much research effort is being directed towards more profoundly hypofractionated (ultrahypofractionated) schedules, with some reaching UK standard of care (e.g. adjuvant breast). Hypofractionation exerts varying influences on each of the major clinical end points of radiotherapy studies: acute toxicity, late toxicity and local control. This review will discuss these effects from the viewpoint of the traditional 5 Rs of radiobiology, before considering non-canonical radiobiological effects that may be relevant to ultrahypofractionated radiotherapy. The principles outlined here may assist the reader in their interpretation of the wealth of clinical data presented in the tumour site-specific articles in this special issue.

Keywords: Hypofractionation; radiobiology.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Breast / pathology
Breast Neoplasms* / radiotherapy
Humans
Male
Prostatic Neoplasms* / radiotherapy
Radiation Dose Hypofractionation
Radiobiology
Treatment Outcome

Abstract

Publication types

MeSH terms

Grants and funding