Exact(46)
A second meta-analysis also including more recent trials in advanced SCCHN found an overall survival benefit of 12 months when adding chemotherapy to normally fractionated radiotherapy or even altered fractionation schedules [ 5].
Accordingly, fractionated radiotherapy with dose escalation or altered fractionation schedule is used to prevent hypoxia and repopulation.
Further well-designed clinical trials that examine RT dose escalation, improved tumor targeting, altered fractionation, and incorporation of biologic agents are crucial for progress in this disease.
Using altered fractionation resulted additionally in an increased locoregional control rate while younger patients apparently have a higher benefit from altered fractionation schedules [ 6].
In addition, altered fractionation regimen resulted in increased locoregional control in all patients though younger patients seemed to benefit most.
The heterogeneity of cancer cells and cancer types and the importance of overall treatment time make altered fractionation more useful in selected cases.
Similar(14)
More recently, trials suggest that local-regional control can be improved with RT dose escalation, improved tumor targeting (eg, 3-dimensional planning and intensity-modulated RT), and altered RT fractionation.
The extent of MN fractionation was controlled by altering the fractionation temperatures.
In a recently published meta-aanalysis, altered dose-fractionation schedules of WBI did not result in significant differences in median survival and local control [ 16], which is different from the findings of the present study.
Due to the sometimes marked side effects in standard chemoradiation regimens using altered-fractionation 3 D conformal radiation techniques, intensification is rarely clinically possible.
Due to lack of standardized protocols for the treatment of adults with medulloblastomas, numerous individual treatment strategies for non-pediatric patients have evolved that abandon combined or adjuvant addition of chemotherapy and alter dosage and fractionation scheme of RT.
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