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Stereotactic radiosurgery (SRS) is a precise focusing of radiation to a targeted point or larger area of tissue. With advances in technology, the radiobiological understanding of this modality has trailed behind. Although found effective in both short- and long-term follow-up, there are ongoing evolution and controversial topics such as dosing pattern, dose per fraction in hypo-fractionnated regimens, inter-fraction interval, and so on. Radiobiology of radiosurgery is not a mere extension of conventional fractionation radiotherapy, but it demands further evaluation of the dose calculation on the linear linear-quadratic model, which has also its limits, biologically effective dose, and radiosensitivity of the normal and target tissue. Further research is undergoing to understand this somewhat controversial topic of radiosurgery better.Keywords:
Radiobiology
Stereotactic radiosurgery (SRS) is a precise focusing of radiation to a targeted point or larger area of tissue. With advances in technology, the radiobiological understanding of this modality has trailed behind. Although found effective in both short- and long-term follow-up, there are ongoing evolution and controversial topics such as dosing pattern, dose per fraction in hypo-fractionnated regimens, inter-fraction interval, and so on. Radiobiology of radiosurgery is not a mere extension of conventional fractionation radiotherapy, but it demands further evaluation of the dose calculation on the linear linear-quadratic model, which has also its limits, biologically effective dose, and radiosensitivity of the normal and target tissue. Further research is undergoing to understand this somewhat controversial topic of radiosurgery better.
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This paper tries to compare the relatively short time in which radiobiology could make a significant contribution to cancer therapy-in contrast to about two decades in which fundamental research into the initial mechanisms of radiobiological damage may be expected to have a significant effect. For the short term, emphasis is given to one way of improving the interaction of clinically required and relevant laboratory research data. The involvement and use of radiobiologists in the clinic and the laboratory can create an awareness of, and help to delineate, the limiting factors facing the clinician. This could guide research towards solving some of these in the laboratory. For example, it is suggested that radiobiology should concentrate on methods which are clinically acceptable for quantitating the dosetime dependence of various normal tissues to radiation (or any non-selective cytotoxic agent in cancer therapy). This would reduce laboratory research oriented towards experimental models for human tumours; it would increase the clinician's acceptance of feasible shorter term measurements by which to assess the effectiveness of innovations in therapy, than could be realized in most clinical trials today.
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