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Fractionation Concepts

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Re-irradiation: New Frontiers

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

This chapter summarizes the principles of fractionated radiotherapy and altered fractionation approaches. Clinical reirradiation examples and isoeffect calculations are provided. The vast majority of published reirradiation series consist of retrospective data or small prospective studies with limited statistical power. In addition, the typical patient populations are more heterogeneous than in first-line radiotherapy studies. For example, patients with local relapse, regional relapse, or second primary tumors might be included. Therefore, the level of evidence is not comparable to that of first-line radiotherapy, where many treatment recommendations and guidelines are based on large and well-designed prospective randomized trials or meta-analyses of several trials. Reirradiation is often used for palliative symptoms but occasionally curative approaches, which require high total radiation doses, might be possible. Hyperfractionated reirradiation might theoretically improve the therapeutic ratio, but prospective trials are required to confirm this hypothesis.

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Authors and Affiliations

  1. Department of Oncology and Palliative Medicine, Nordland Hospital, Prinsensgate 164, 8092, Bodø, Norway

    Carsten Nieder

  2. Department of Radiation Oncology, University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany

    Michael Baumann

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  1. Carsten Nieder
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  2. Michael Baumann
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Correspondence to Carsten Nieder .

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Editors and Affiliations

  1. , Dept. Internal Medicine, Nordlandssykehuset HF, Prinsensgate 164, Bodoe, 8092, Norway

    Carsten Nieder

  2. Department of Radiation Oncology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, Netherlands

    Johannes A. Langendijk

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Nieder, C., Baumann, M. (2010). Fractionation Concepts. In: Nieder, C., Langendijk, J. (eds) Re-irradiation: New Frontiers. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2010_77

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  • DOI: https://doi.org/10.1007/174_2010_77

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  • Print ISBN: 978-3-642-12467-9

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