Fractionation Concepts

  • Carsten Nieder
  • Michael Baumann
Part of the Medical Radiology book series (MEDRAD)


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.


Rectal Cancer Stereotactic Body Radiotherapy Late Toxicity Biologically Effective Dose Fractionation Regimen 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Department of Oncology and Palliative MedicineNordland HospitalBodøNorway
  2. 2.Department of Radiation OncologyUniversity Hospital Carl Gustav CarusDresdenGermany

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