Tk, Tdelay [1],
or Tdel [2] "represents any delay in the start of tumour cell
repopulation in response to radiation treatment after radiation treatment has
started." Repopulation of tumour cells due to radiation treatment starts
after a passed lag period of Tk treatment days [3]. The repopulation time of tumour cells
appears to vary during radiotherapy; at the commencement it may be slow (e.g., due to hypoxia); however, a certain
time after the first fraction of radiotherapy (kick-off time), repopulation
accelerates [4]. Tk is "the apparent starting time of
rapid compensatory repopulation in tumor or tissue after the start of
treatment, when it is assumed that there are just two rates of cell
proliferation during radiotherapy: zero from start to Tk, then
constant doubling each Tp days [cell doubling time] until
end of treatment at T days [overall treatment time]" [5].
Tk could be between 21 and
32 days in human head and neck tumors [6,7] and non-small-cell lung
cancer, and unlikely may be shorter, but may be longer in prostate cancer [8]. Fowler et al. [9] considered that
prostate cancer would have a TK value
up to 10 times the TK for
head and neck tumors, approximately between 210 and 300 days, and Leborgne et
al. [10] considered a TK for prostate cancer of 52 days. Values for adenocarcinoma of the anus have not been defined [11].
Bibliographic references:
[1] The timely delivery of radical radiotherapy: standards and guidelines for the management of unscheduled treatment interruptions. (2008). 3rd ed. London, United Kingdom: Board of Faculty of Clinical Oncology, The Royal College of Radiologists. Available at: https://www.rcr.ac.uk/sites/default/files/publication/BFCO(08)6_Interruptions.pdf [Accessed 17 Jul. 2016].
[2] Wyatt RM, Beddoe AH, Dale RG. The effects of delays in radiotherapy treatment on tumour control. Phys Med Biol. 2003 Jan 21;48(2):139-55. Available at: http://dx.doi.org/10.1088/0031-9155/48/2/301.
[1] The timely delivery of radical radiotherapy: standards and guidelines for the management of unscheduled treatment interruptions. (2008). 3rd ed. London, United Kingdom: Board of Faculty of Clinical Oncology, The Royal College of Radiologists. Available at: https://www.rcr.ac.uk/sites/default/files/publication/BFCO(08)6_Interruptions.pdf [Accessed 17 Jul. 2016].
[2] Wyatt RM, Beddoe AH, Dale RG. The effects of delays in radiotherapy treatment on tumour control. Phys Med Biol. 2003 Jan 21;48(2):139-55. Available at: http://dx.doi.org/10.1088/0031-9155/48/2/301.
[3] Tomé WA, Fowler JF. On the inclusion of proliferation in tumour control probability calculations for inhomogeneously irradiated tumours. Phys Med Biol. 2003 Sep 21;48(18):N261-8. Available at: http://dx.doi.org/10.1088/0031-9155/48/18/402.
[4] IAEA Training Material on Radiation Protection in Radiotherapy - Radiation Protection in Radiotherapy - Part 3 - Biological Effects - Lecture 2: High Doses in Radiation Therapy. (2013). [Lectures/Slides]. Vienna, Austria: International Atomic Energy Agency. Available at: https://rpop.iaea.org/RPOP/RPoP/Content/Documents/TrainingRadiotherapy/Lectures/RT03_RadBiol2_RT_WEB.ppt [Accessed 12 Jul. 2016].
[5] Fowler, J. (2006). Part I: Basic Concepts in Treatment Planning, 1. Practical Time-Dose Evaluations, or How to Stop Worrying and Learn to Love Linear Quadratics. In: S. Levitt, J. Purdy, C. Perez and S. Vijayakumar, ed., Technical Basis of Radiation Therapy, Practical Clinical Applications, 4th ed. Springer-Verlag Berlin Heidelberg, pp.3-31.
[6] Brenner, DJ. Accelerated repopulation during radiotherapy. Quantitative evidence for delayed onset. Radiat Oncol Invest. 1993;1(3):167–72. Available at: http://dx.doi.org/10.1002/roi.2970010306.
[7] Roberts, SA, Hendry, JH. Time factors in larynx tumor radiotherapy: lag times and intertumor heterogeneity in clinical datasets from four centers. Int J Radiat Oncol Biol Phys. 1999;45(5):1247–57. Available at: http://dx.doi.org/10.1016/s0360-3016(99)00320-x.
[8] Fowler JF. Development of radiobiology for oncology—a personal view. Phys Med Biol. 2006 Jul 7;51(13):R263-86. Available at: http://dx.doi.org/10.1088/0031-9155/51/13/R16.
[9] Fowler, JF, Ritter, MA, Fenwick , JD, Chappell, RJ. How low is the alpha/beta ratio for prostate cancer? In regard to Wang et al., IJROBP 2003;55:194-203, Int J Radiat Oncol Biol Phys. 2003;57(2):593–5. Available at: http://dx.doi.org/10.1016/s0360-3016(03)00364-x.
[8] Fowler JF. Development of radiobiology for oncology—a personal view. Phys Med Biol. 2006 Jul 7;51(13):R263-86. Available at: http://dx.doi.org/10.1088/0031-9155/51/13/R16.
[9] Fowler, JF, Ritter, MA, Fenwick , JD, Chappell, RJ. How low is the alpha/beta ratio for prostate cancer? In regard to Wang et al., IJROBP 2003;55:194-203, Int J Radiat Oncol Biol Phys. 2003;57(2):593–5. Available at: http://dx.doi.org/10.1016/s0360-3016(03)00364-x.
[10] Leborgne, F, Fowler, J, Leborgne, JH, Mezzera, J. Later
outcomes and alpha/beta estimate from hypofractionated conformal
threediomensional radiotherapy versus standard fractionation for localized
prostate cancer. Int J Radiat Oncol Biol Phys. 2012;82(3):1200–7. Available at: http://dx.doi.org/10.1016/j.ijrobp.2010.12.040.
[11] Joon DL, Chao MW, Ngan SY, Joon ML, Guiney MJ. Primary adenocarcinoma of the anus: a retrospective analysis. Int J Radiat Oncol Biol Phys. 1999 Dec 1;45(5):1199-205. Available at: http://dx.doi.org/10.1016/S0360-3016(99)00267-9.
[11] Joon DL, Chao MW, Ngan SY, Joon ML, Guiney MJ. Primary adenocarcinoma of the anus: a retrospective analysis. Int J Radiat Oncol Biol Phys. 1999 Dec 1;45(5):1199-205. Available at: http://dx.doi.org/10.1016/S0360-3016(99)00267-9.
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