Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy
Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Xue, Jinyu [verfasserIn] Emami, Bahman [verfasserIn] Grimm, Jimm [verfasserIn] Kubicek, Gregory J. [verfasserIn] Asbell, Sucha O. [verfasserIn] Lanciano, Rachelle [verfasserIn] Welsh, James S. [verfasserIn] Peng, Luke [verfasserIn] Quon, Harry [verfasserIn] Laub, Wolfram [verfasserIn] Gui, Chengcheng [verfasserIn] Spoleti, Nicholas [verfasserIn] Das, Indra J. [verfasserIn] Goldman, Howard Warren [verfasserIn] Redmond, Kristin J. [verfasserIn] Kleinberg, Lawrence R. [verfasserIn] Brady, Luther W. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Übergeordnetes Werk: |
Enthalten in: Journal of radiation oncology - Berlin : Springer, 2012, 7(2018), 4 vom: Dez., Seite 293-305 |
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| Übergeordnetes Werk: |
volume:7 ; year:2018 ; number:4 ; month:12 ; pages:293-305 |
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| DOI / URN: |
10.1007/s13566-018-0367-2 |
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| Katalog-ID: |
SPR031813143 |
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| 520 | |a Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. | ||
| 650 | 4 | |a Radiosurgery |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Radiotherapy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Fractionation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Toxicities |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Biologically effective dose |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Outcomes |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Emami, Bahman |e verfasserin |4 aut | |
| 700 | 1 | |a Grimm, Jimm |e verfasserin |4 aut | |
| 700 | 1 | |a Kubicek, Gregory J. |e verfasserin |4 aut | |
| 700 | 1 | |a Asbell, Sucha O. |e verfasserin |4 aut | |
| 700 | 1 | |a Lanciano, Rachelle |e verfasserin |4 aut | |
| 700 | 1 | |a Welsh, James S. |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Luke |e verfasserin |4 aut | |
| 700 | 1 | |a Quon, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a Laub, Wolfram |e verfasserin |4 aut | |
| 700 | 1 | |a Gui, Chengcheng |e verfasserin |4 aut | |
| 700 | 1 | |a Spoleti, Nicholas |e verfasserin |4 aut | |
| 700 | 1 | |a Das, Indra J. |e verfasserin |4 aut | |
| 700 | 1 | |a Goldman, Howard Warren |e verfasserin |4 aut | |
| 700 | 1 | |a Redmond, Kristin J. |e verfasserin |4 aut | |
| 700 | 1 | |a Kleinberg, Lawrence R. |e verfasserin |4 aut | |
| 700 | 1 | |a Brady, Luther W. |e verfasserin |4 aut | |
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10.1007/s13566-018-0367-2 doi (DE-627)SPR031813143 (SPR)s13566-018-0367-2-e DE-627 ger DE-627 rakwb eng 610 ASE Xue, Jinyu verfasserin aut Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. Radiosurgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Fractionation (dpeaa)DE-He213 Toxicities (dpeaa)DE-He213 Biologically effective dose (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Emami, Bahman verfasserin aut Grimm, Jimm verfasserin aut Kubicek, Gregory J. verfasserin aut Asbell, Sucha O. verfasserin aut Lanciano, Rachelle verfasserin aut Welsh, James S. verfasserin aut Peng, Luke verfasserin aut Quon, Harry verfasserin aut Laub, Wolfram verfasserin aut Gui, Chengcheng verfasserin aut Spoleti, Nicholas verfasserin aut Das, Indra J. verfasserin aut Goldman, Howard Warren verfasserin aut Redmond, Kristin J. verfasserin aut Kleinberg, Lawrence R. verfasserin aut Brady, Luther W. verfasserin aut Enthalten in Journal of radiation oncology Berlin : Springer, 2012 7(2018), 4 vom: Dez., Seite 293-305 (DE-627)718611233 (DE-600)2660511-9 1948-7908 nnns volume:7 year:2018 number:4 month:12 pages:293-305 https://dx.doi.org/10.1007/s13566-018-0367-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 7 2018 4 12 293-305 |
| spelling |
10.1007/s13566-018-0367-2 doi (DE-627)SPR031813143 (SPR)s13566-018-0367-2-e DE-627 ger DE-627 rakwb eng 610 ASE Xue, Jinyu verfasserin aut Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. Radiosurgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Fractionation (dpeaa)DE-He213 Toxicities (dpeaa)DE-He213 Biologically effective dose (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Emami, Bahman verfasserin aut Grimm, Jimm verfasserin aut Kubicek, Gregory J. verfasserin aut Asbell, Sucha O. verfasserin aut Lanciano, Rachelle verfasserin aut Welsh, James S. verfasserin aut Peng, Luke verfasserin aut Quon, Harry verfasserin aut Laub, Wolfram verfasserin aut Gui, Chengcheng verfasserin aut Spoleti, Nicholas verfasserin aut Das, Indra J. verfasserin aut Goldman, Howard Warren verfasserin aut Redmond, Kristin J. verfasserin aut Kleinberg, Lawrence R. verfasserin aut Brady, Luther W. verfasserin aut Enthalten in Journal of radiation oncology Berlin : Springer, 2012 7(2018), 4 vom: Dez., Seite 293-305 (DE-627)718611233 (DE-600)2660511-9 1948-7908 nnns volume:7 year:2018 number:4 month:12 pages:293-305 https://dx.doi.org/10.1007/s13566-018-0367-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 7 2018 4 12 293-305 |
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10.1007/s13566-018-0367-2 doi (DE-627)SPR031813143 (SPR)s13566-018-0367-2-e DE-627 ger DE-627 rakwb eng 610 ASE Xue, Jinyu verfasserin aut Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. Radiosurgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Fractionation (dpeaa)DE-He213 Toxicities (dpeaa)DE-He213 Biologically effective dose (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Emami, Bahman verfasserin aut Grimm, Jimm verfasserin aut Kubicek, Gregory J. verfasserin aut Asbell, Sucha O. verfasserin aut Lanciano, Rachelle verfasserin aut Welsh, James S. verfasserin aut Peng, Luke verfasserin aut Quon, Harry verfasserin aut Laub, Wolfram verfasserin aut Gui, Chengcheng verfasserin aut Spoleti, Nicholas verfasserin aut Das, Indra J. verfasserin aut Goldman, Howard Warren verfasserin aut Redmond, Kristin J. verfasserin aut Kleinberg, Lawrence R. verfasserin aut Brady, Luther W. verfasserin aut Enthalten in Journal of radiation oncology Berlin : Springer, 2012 7(2018), 4 vom: Dez., Seite 293-305 (DE-627)718611233 (DE-600)2660511-9 1948-7908 nnns volume:7 year:2018 number:4 month:12 pages:293-305 https://dx.doi.org/10.1007/s13566-018-0367-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 7 2018 4 12 293-305 |
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10.1007/s13566-018-0367-2 doi (DE-627)SPR031813143 (SPR)s13566-018-0367-2-e DE-627 ger DE-627 rakwb eng 610 ASE Xue, Jinyu verfasserin aut Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. Radiosurgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Fractionation (dpeaa)DE-He213 Toxicities (dpeaa)DE-He213 Biologically effective dose (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Emami, Bahman verfasserin aut Grimm, Jimm verfasserin aut Kubicek, Gregory J. verfasserin aut Asbell, Sucha O. verfasserin aut Lanciano, Rachelle verfasserin aut Welsh, James S. verfasserin aut Peng, Luke verfasserin aut Quon, Harry verfasserin aut Laub, Wolfram verfasserin aut Gui, Chengcheng verfasserin aut Spoleti, Nicholas verfasserin aut Das, Indra J. verfasserin aut Goldman, Howard Warren verfasserin aut Redmond, Kristin J. verfasserin aut Kleinberg, Lawrence R. verfasserin aut Brady, Luther W. verfasserin aut Enthalten in Journal of radiation oncology Berlin : Springer, 2012 7(2018), 4 vom: Dez., Seite 293-305 (DE-627)718611233 (DE-600)2660511-9 1948-7908 nnns volume:7 year:2018 number:4 month:12 pages:293-305 https://dx.doi.org/10.1007/s13566-018-0367-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 7 2018 4 12 293-305 |
| allfieldsSound |
10.1007/s13566-018-0367-2 doi (DE-627)SPR031813143 (SPR)s13566-018-0367-2-e DE-627 ger DE-627 rakwb eng 610 ASE Xue, Jinyu verfasserin aut Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. Radiosurgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Fractionation (dpeaa)DE-He213 Toxicities (dpeaa)DE-He213 Biologically effective dose (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Emami, Bahman verfasserin aut Grimm, Jimm verfasserin aut Kubicek, Gregory J. verfasserin aut Asbell, Sucha O. verfasserin aut Lanciano, Rachelle verfasserin aut Welsh, James S. verfasserin aut Peng, Luke verfasserin aut Quon, Harry verfasserin aut Laub, Wolfram verfasserin aut Gui, Chengcheng verfasserin aut Spoleti, Nicholas verfasserin aut Das, Indra J. verfasserin aut Goldman, Howard Warren verfasserin aut Redmond, Kristin J. verfasserin aut Kleinberg, Lawrence R. verfasserin aut Brady, Luther W. verfasserin aut Enthalten in Journal of radiation oncology Berlin : Springer, 2012 7(2018), 4 vom: Dez., Seite 293-305 (DE-627)718611233 (DE-600)2660511-9 1948-7908 nnns volume:7 year:2018 number:4 month:12 pages:293-305 https://dx.doi.org/10.1007/s13566-018-0367-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 7 2018 4 12 293-305 |
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Enthalten in Journal of radiation oncology 7(2018), 4 vom: Dez., Seite 293-305 volume:7 year:2018 number:4 month:12 pages:293-305 |
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Radiosurgery Radiotherapy Fractionation Toxicities Biologically effective dose Outcomes |
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Xue, Jinyu @@aut@@ Emami, Bahman @@aut@@ Grimm, Jimm @@aut@@ Kubicek, Gregory J. @@aut@@ Asbell, Sucha O. @@aut@@ Lanciano, Rachelle @@aut@@ Welsh, James S. @@aut@@ Peng, Luke @@aut@@ Quon, Harry @@aut@@ Laub, Wolfram @@aut@@ Gui, Chengcheng @@aut@@ Spoleti, Nicholas @@aut@@ Das, Indra J. @@aut@@ Goldman, Howard Warren @@aut@@ Redmond, Kristin J. @@aut@@ Kleinberg, Lawrence R. @@aut@@ Brady, Luther W. @@aut@@ |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR031813143</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519141843.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2018 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s13566-018-0367-2</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR031813143</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s13566-018-0367-2-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Xue, Jinyu</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. 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|
| author |
Xue, Jinyu |
| spellingShingle |
Xue, Jinyu ddc 610 misc Radiosurgery misc Radiotherapy misc Fractionation misc Toxicities misc Biologically effective dose misc Outcomes Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy |
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Xue, Jinyu |
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@@773@@(DE-627)718611233 |
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electronic Article |
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610 - Medicine & health |
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keep |
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springer |
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true |
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Not Illustrated |
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1948-7908 |
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610 ASE Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy Radiosurgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Fractionation (dpeaa)DE-He213 Toxicities (dpeaa)DE-He213 Biologically effective dose (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 |
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ddc 610 misc Radiosurgery misc Radiotherapy misc Fractionation misc Toxicities misc Biologically effective dose misc Outcomes |
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ddc 610 misc Radiosurgery misc Radiotherapy misc Fractionation misc Toxicities misc Biologically effective dose misc Outcomes |
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ddc 610 misc Radiosurgery misc Radiotherapy misc Fractionation misc Toxicities misc Biologically effective dose misc Outcomes |
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Elektronische Aufsätze Aufsätze Elektronische Ressource |
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Journal of radiation oncology |
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Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy |
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Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy |
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Xue, Jinyu |
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Journal of radiation oncology |
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Xue, Jinyu Emami, Bahman Grimm, Jimm Kubicek, Gregory J. Asbell, Sucha O. Lanciano, Rachelle Welsh, James S. Peng, Luke Quon, Harry Laub, Wolfram Gui, Chengcheng Spoleti, Nicholas Das, Indra J. Goldman, Howard Warren Redmond, Kristin J. Kleinberg, Lawrence R. Brady, Luther W. |
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Elektronische Aufsätze |
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Xue, Jinyu |
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10.1007/s13566-018-0367-2 |
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clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy |
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Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy |
| abstract |
Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. |
| abstractGer |
Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. |
| abstract_unstemmed |
Background Stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and stereotactic ablative body radiotherapy (SABR) are commonly used in the treatment of central nervous system (CNS) disease. This study has refined the radiation toxicity estimates for some normal tissues of the CNS based on review and analysis of the clinical evidence for single fraction radiosurgery, hypofractionated SBRT, and conventionally fractionated radiation therapy. Methods Published guidelines and protocols are reviewed. In the past, many normal tissue tolerances were compiled based on the experience of the investigators and publications in the literature. Some tolerances were determined by modeling or calculation using the existing biological formulas, in particular the linear quadratic (LQ) model. In the present study, the estimate of risk for each dose tolerance limit in some CNS tissues is provided exclusively with normal tissue complication probability (NTCP). The clinical outcomes are compared to understand the difference in biological effect between radiosurgery and radiotherapy. Results Normal tissue dose tolerances and the corresponding complication rates are provided for brainstem, optic nerves, cochlea, and spinal cord, including single fraction SRS, five-fraction SBRT, and conventional radiation therapy. Calculation of biologically effective dose (BED) or single fraction equivalent dose (SFED) alone using the LQ model conveys no consensus on the biological effect across different fractionations. Comparison of conventional radiation therapy to brain and spinal cord with single fraction equivalent dose leads to even conflicting clinical outcomes. Conclusions Effective differences between single fraction SRS and conventional radiotherapy need to be better understood. The existing biological model might not be valid to predict the radiosurgical outcomes based on conventionally fractionated radiotherapy. However, application of the statistical dose response models of clinical SRS and SBRT outcomes data to selected current dose tolerance guidelines into simple tables can be a clinically useful resource. |
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Clinical evidence for dose tolerance of the central nervous system in hypofractionated radiotherapy |
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Emami, Bahman Grimm, Jimm Kubicek, Gregory J. Asbell, Sucha O. Lanciano, Rachelle Welsh, James S. Peng, Luke Quon, Harry Laub, Wolfram Gui, Chengcheng Spoleti, Nicholas Das, Indra J. Goldman, Howard Warren Redmond, Kristin J. Kleinberg, Lawrence R. Brady, Luther W. |
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Emami, Bahman Grimm, Jimm Kubicek, Gregory J. Asbell, Sucha O. Lanciano, Rachelle Welsh, James S. Peng, Luke Quon, Harry Laub, Wolfram Gui, Chengcheng Spoleti, Nicholas Das, Indra J. Goldman, Howard Warren Redmond, Kristin J. Kleinberg, Lawrence R. Brady, Luther W. |
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| score |
7.400485 |