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Should BED or EQD2 be used when deciding on a fractionation scheme for breast cancer radiation, and should tumor or normal tissue be prioritized in this consideration?

3 Answers
Mednet Member
Mednet Member
Radiation Oncology · Varian Medical Systems/Allegheny health network

I feel, with many prospective randomized data, we are beyond looking at EQ2 dose for deciding fractionation. We follow the below rationale/pathway in our practice.

  1. Is biology suitable for PBI or not? (If suitable then plan for 30 Gy in 5 fractions like Italian data)
  2. Biology is suitable for PBI but ...

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Mednet Member
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Radiation Oncology · UNC School of Medicine

This is an interesting question. Given the large number of clinical trials that we can use to guide our therapeutic decisions, we really do not need to use models (e.g. BED calculations) to define a prescription. I have never seen a prescription written in "BED units". Indeed, if one were to use the...

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Mednet Member
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Radiation Oncology · Phoenix CyberKnife and Radiation Oncology Center

Is this a trick question?

EQD2 and BED are one and the same. Both are calculated using the linear quadratic model and simply express the same values normalized to different scales, similar to expressing a temperature in degrees Fahrenheit or Celsius.

I think the real question is: What is the alpha/...

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