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Radiobiology of stereotactic radiotherapy
Authors:Monica Mangoni  Simona Borghesi  Cynthia Aristei  Carlotta Becherini
Institution:1.Radiotherapy Unit, Oncology Department, Azienda Ospedaliera Universitaria Careggi, University of Florence, Italy; 2.Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Italy; 3.Radiation Oncology Section, University of Perugia and Perugia General Hospital, Italy
Abstract:This paper focuses on the radiobiological mechanisms underlying the effects of stereotactic radiotherapy (SRT ) which, despite SRT expansion, have not yet been fully elucidated. Some authors postulated that radiobiology principles, as applied to conventional fractionations (5R: reoxygenation, repair, repopulation, redistribution, radioresistence), suffice in themselves to account for the excellent clinical results of SRT; others argued that the role of the 5R was limited. Recent preclinical data showed that hypofractionated ablative treatments altered the microenvironment, thus determining cell death either directly or indirectly. Furthermore, dead tumor cells released quantities of antigens, which stimulated antitumor immunity, thus reducing the risk of relapse and metastasis. Better understanding of the radiobiological mechanisms underlying response to high-dose radiation treatment is essential for predicting its short- and long-term effects on the tumor and surrounding healthy tissues and, consequently, for improving its related therapeutic index.
Keywords:stereotactic radiotherapy  radiobiology  radiosurgery
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