title: Hypofractionation in prostate cancer: radiobiological basis and clinical appliance.
abstract: External beam radiation therapy with conventional fractionation to a total dose of 76-80 Gy represents the most adopted treatment modality for prostate cancer. Dose escalation in this setting has been demonstrated to improve biochemical control with acceptable toxicity using contemporary radiotherapy techniques. Hypofractionated radiotherapy and stereotactic body radiation therapy have gained an increasing interest in recent years and they have the potential to become the standard of care even if long-term data about their efficacy and safety are not well established. Strong radiobiological basis supports the use of high dose for fraction in prostate cancer, due to the demonstrated exceptionally low values of α / β . Clinical experiences with hypofractionated and stereotactic radiotherapy (with an adequate biologically equivalent dose) demonstrated good tolerance, a PSA control comparable to conventional fractionation, and the advantage of shorter time period of treatment. This paper reviews the radiobiological findings that have led to the increasing use of hypofractionation in the management of prostate cancer and briefly analyzes the clinical experience in this setting.
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mangoni
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Desideri
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Detti
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Bonomo
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Greto
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Paiar
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Simontacchi
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Meattini
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Scoccianti
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Masoni
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ciabatti
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Turkaj
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Serni
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Minervini
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gacci
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Carini
authors.affiliation: Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Livi
mesh_terms: D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011829:Radiation Dosage; D016634:Radiosurgery / Q000379:methods*