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series (7)(8)(9). Of course, there are many reasons for associations to exist between early and late normal tissue effects. Consequential mechanisms are only one. Presently, therefore, it is reasonable to conclude that although the observed clinical associations do not confirm that consequential mechanisms contribute to delayed rectal injury, this possibility must be borne in mind until contradictory evidence emerges. Obviously, it would be unwise to discount the potential influence of consequential mechanisms on the development of delayed rectal injury. If treatment courses comprising 10 fractional doses as high as 4.8 Gy, as suggested by Fowler et al. are used in future trials, their delivery over 3 weeks or less could be courting disaster (2). Potential gains in therapeutic ratio resulting from differential fractionation sensitivity could be entirely lost. Indeed, a reduction in therapeutic ratio could eventuate. Fowler et al. pointed out that prostate cancer does not seem to proliferate quickly. Although they may therefore be right in asserting that "no overall-time factor is necessary for prostatic tumors" (within certain limits), it should be pointed out that there is also no

Who reads In regard to Antonadou et al., IJROBP 2001;51:915?

Author

Bernard Dubray; Frédéric Dhermain

Publisher

Elsevier Science; Elsevier ; Elsevier BV (ISSN 0360-3016)

Published

2002

Language

EN

Field

Medicine (Health Sciences)