A randomised phase II trial was initiated to explore the feasibility of concomitant cisplatin and radiotherapy with conventional fractionation (CF) or multiple fractions per day (MFD) for patients with locally advanced head and neck malignancies.
Using the CMA algorithm, the classification results for cell morphology show that the number of abnormal chromosomes that CNAs (for cases with multiple fractions tested, the average abnormal chromosomes of all fractions are used) is significantly smaller (p-values are close to zero) in low grade MDS cases than it is in patients with high MDS cases using CMA.
The argument was based on the concept that hypoxic cells could reestablish their oxygenated state and become more sensitive to irradiation when treated with multiple fractions.
Moreover, although the prophylactic role of WBRT in some cancers has been demonstrated [ 21], prolonged treatment duration with multiple fractions may not be possible in elderly patients.
For example, patients in the RAPID trial that underwent hypofractionated treatment with multiple fractions per day (38.5 Gy in 10 fractions over a week) suffered from greater normal tissue toxicity than those in the control arm (42.5 Gy in 16 fractions) [25].
Stem cell transplant is a complicated process with many effective approaches (eg. types chemotherapy used, done with or without TBI) and a multitude of variations (eg. dose of chemotherapy used, single fraction or multiple fraction TBI with or without lung dose reduction, low dose).
The effect of the drug was evaluated in combination with hypobaric hypoxia and with radiation (single and multiple fractions).
Multiple fractions of 5.0 Gy each given with 4, 12, and 24 hr intervals showed an increase in survival with increasing interfractional time interval, suggesting a rapid repopulation of tumor cells between fractions; namely, cell doubling time was shortened between fractions after the first 5.0 Gy doses.
Accordingly, radiation was applied in daily multiple fractions and drugs were administered concurrently with radiotherapy.
Hird studied 111 patients with uncomplicated painful bone metastases and showed an incidence of pain flare of 40%, with no difference between single or multiple fractions.
