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Physical Models For Time Dose & Fractionation

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Physical Models For Time Dose & Fractionation
Strandqvist Plot
Cohen’s Formula
Fowler Concepts
NSD Model
TDF model
Target Theory
L Q model
BED calculation of different fractionation regimen

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Physical Models For Time Dose & Fractionation

  1. 1. PHYSICAL MODELS FOR TIME DOSE & FRACTIONATION
  2. 2. TIME DOSE MODELS • Strandquist was 1st to device scientific approach for correlating Dose to OTT to produce an equivalent biological isoeffect (Isoeffect Curve)
  3. 3. Radiation Induced Cell Death
  4. 4. c
  5. 5. 35# of 2 Gy/# once a day for 5 days/ week, for an overall treatment time of 7 weeks; that is, 35F 2 Gy/7 weeks Treatment: conventional
  6. 6. hyperfractionation more effective for tumor control (84vs.89.8Gy10),& also better for late effects (116.7 vs. 111.4 Gy3) CLINICAL PRACTICE
  7. 7. concomitant boost is hotter than conventional schedule (6 WEEKS) for both early(84.4Gy vs72Gy) and late effects(113.4Gy vs100 Gy) Compared with hyperfractionation, however, this concomitant boost is almost the same for late effects(113.4Gy vs 111.4Gy) but less effective for early effects including tumor control(84.4 Gy vs89.8Gy)
  8. 8. • Direct comparison of CHART with the previous examples in terms of Gy10 and Gy3 is meaningless because CHART has an overall time of only 12 days compared with 6 or 7 weeks for the other schedules
  9. 9. MARCH META-ANALYSIS 2006 2010 2017 The Lancet, Volume 368, Issue 9538, Pages 843 - 854, 2 September 2006
  10. 10. 15 Randomized Trials of Varied Fractionation (1970-1998) PATIENT CHARACTERISTICS 7073 patients Tumours sites: mostly oropharynx and larynx hyper fractionated accelerated accelerated with total dose reduction Overall survival was the main endpoint median follow up:6 yr
  11. 11. benefit Conventional vs Altered Hyper fractionation vs Accelerated fractionation 1. Locoregional control Loco regional control 6.4 %times higher benefit was higher with hyper fractionated radiotherapy ( OS 8% at 5 years) than with accelerated radiotherapy 2. Survival benefit absolute benefit of 3·4% at 5 years with altered fractionated radiotherapy,
  12. 12. UPDATE (2017)
  13. 13. THANKYOU
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Physical Models For Time Dose & Fractionation Strandqvist Plot Cohen’s Formula Fowler Concepts NSD Model TDF model Target Theory L Q model BED calculation of different fractionation regimen

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