Radiobiological Meta-Analysis of the Response of Prostate Cancer to High-Dose-Rate Brachytherapy: Investigation of the Reduction in Control for Extreme Hypofractionation

Our analysis showed that the substantial loss of tumor control observed in extremely hypofractionated HDR-BT trials can only be explained by the LQ model if the α/β is very large (≥100 Gy), in clear disagreement with the limits set in the analysis of external radiotherapy data. It seems more reasonable that there is a moderation of the LQ-predicted effect with increasing dose per fraction. These results may assist in the design of radical HDR-BT treatments.