We will limit this article to five areas in the field of radiation oncology selected not only because of their importance but also because some of these developments may not have been recognized in other disciplines. The five areas to be discussed herein are altered radiation fractionation techniques, physical optimization of dose distribution, drug-radiation interaction, radiation-induced gene induction, and radioactive antibodies as part of systemic therapy.
Fractionation of radiation into small divided increments is the basis of conventional radiation therapy. It has been successful because it exerts a differential effect on tumors and healthy tissues. As we have learned more about the kinetics of repair and proliferation of these cell populations, there has been increasing experience in amplifying the difference between tumors and healthy tissue by increasing the number of daily fractions of reduced dose (hyperfractionation) and of giving conventional fractions over shorter periods (accelerated fractionation). Pilot studies of both
Hellman S, Weichselbaum RR. Radiation Oncology. JAMA. 1994;271(21):1712-1714. doi:10.1001/jama.1994.03510450084047