Extreme hypofractionation for prostate cancer

Abstract

In ideal circumstances the fractionation schedule of radiotherapy should match the fractionation sensitivity of the tumor relative to the nearby normal tissues. A number of recent publications have suggested that the α/β ratio for prostate tumors is low – in the range of 1–3 Gy. In fact, if α/β is low, then hypofractionated schedules using fewer, larger fractions should improve the therapeutic ratio. This critical article examines two methods that represent schedules at the extreme end of the fractionation spectrum (3–5 fractions): high-dose-rate brachytherapy as monotherapy and stereotactic body radiotherapy.

Keywords::

• high-dose-rate brachytherapy
• hypofractionation
• prostate cancer
• radiotherapy
• stereotactic radiotherapy

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.