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01.09.2015 | Original Article

DEGRO practical guidelines for radiotherapy of non-malignant disorders

Part I: physical principles, radiobiological mechanisms, and radiogenic risk

verfasst von: Berthold Reichl, Dipl.-Phys., Andreas Block, PhD, Ulrich Schäfer, MD, Christoph Bert, PhD, Reinhold Müller, PhD, Horst Jung, PhD, Franz Rödel, PhD, the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD)

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 9/2015

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Abstract

Purpose

Synopsis of the introductory paragraph of the DEGRO consensus S2e-guideline recommendations for the radiotherapy of benign disorders, including physical principles, radiobiological mechanisms, and radiogenic risk.

Materials and methods

This work is based on the S2e-guideline recommendations published November 14, 2013. The basic principles of radiation physics and treatment delivery, evaluation of putative underlying radiobiological mechanisms, and the assessment of genetic and cancer risk following low-dose irradiation will be presented.

Results

Radiation therapy of benign diseases is performed according to similar physical principles as those governing treatment of malignant diseases in radiation oncology, using the same techniques and workflows. These methods comprise usage of orthovoltage X-ray units, gamma irradiation facilities, linear accelerators (LINACs), and brachytherapy. Experimental in vitro and in vivo models recently confirmed the clinically observed anti-inflammatory effect of low-dose X-irradiation, and implicated a multitude of radiobiological mechanisms. These include modulation of different immunological pathways, as well as the activities of endothelial cells, mono- and polymorphonuclear leukocytes, and macrophages. The use of effective dose for radiogenic risk assessment and the corresponding tumor incidence rate of 5.5 %/Sv are currently controversially discussed. Some authors argue that the risk of radiation-induced cancers should be estimated on the basis of epidemiological data. However, such data are rarely available at present and associated with high variability.

Conclusion

Current radiobiological studies clearly demonstrate a therapeutic effectiveness of radiation therapy used to treat benign diseases and implicate various molecular mechanisms. Radiogenic risks should be taken into account when applying radiation treatment for benign diseases.

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Titel: DEGRO practical guidelines for radiotherapy of non-malignant disorders
Part I: physical principles, radiobiological mechanisms, and radiogenic risk
verfasst von: Berthold Reichl, Dipl.-Phys.
Andreas Block, PhD
Ulrich Schäfer, MD
Christoph Bert, PhD
Reinhold Müller, PhD
Horst Jung, PhD
Franz Rödel, PhD
the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD)
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 9/2015
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0865-8

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DEGRO practical guidelines for radiotherapy of non-malignant disorders

Part I: physical principles, radiobiological mechanisms, and radiogenic risk