Equivalent total doses for different fractionation schemes, based on the linear quadratic model.

Abstract

A majority of patients receiving radical radiation therapy are treated with 1.8-2.0-Gy fractions, a dose that has evolved from clinical experience. However, other fractionation schemes can be advantageous. When fractionation is altered, the total dose prescribed should lead to equivalent or higher tumor control with the same or less tissue toxicity. To facilitate the use of different fractionation schemes, the authors compiled tables for equivalent biologic doses for late toxicity in normal tissues and tumoricidal doses for epithelial tumors, for various fraction sizes. The linear quadratic model according to Fowler was used. It is shown how these tables should be modified for proliferation of tumors during the course of radiation therapy. The tables make the use of different fractionation schemes easy. They also allow adjustment of total dose if fractionation needs to be changed during the course of treatment.