Most often radiation therapy is given in small doses throughout several weeks through an outpatient facility.  This is especially true of external beam radiation therapy given with the use of a linear accelerator.  Most often radiation will only be administered once a day but occasionally can be given twice daily if recommended.

For most patients receiving radiation therapy as part of their cancer treatment external beam radiation therapy will be given once daily using a linear accelerator.  The treatment is delivered in this manner because a once daily treatment plan helps to minimize the amount of damage that is done to the healthy tissue and normal cells surrounding the cancerous tumors and cells.   Also the likelihood of exposing radiation to cancerous cells during the cell cycle when they are most susceptible to DNA damage increases.

Three other methods in which to distribute radiation have been tested including:

Hypo-fractionation: In order to reduce the number of treatments needed, hypo-fractionation is given in larger doses either once a day or less.

Hyper-fractionation: It is the opposite of hypo-fractionation; smaller doses are given throughout multiple treatments a day.

Accelerated Fractionation: In order to reduce the number of weeks treatment is needed, accelerated fractionation allows treatment to be given in larger doses on a daily or weekly basis.

The hope is to find different options that make receiving treatment more convenient to patients without sacrificing the effectiveness of the therapy.

Patients most often receive radiation therapy before, during or after surgery.  In some patients therapy is given using linear accelerators only without other treatments or surgery while others receive chemotherapy and radiation therapy without surgery.  This will vary due to a number of factors.  The exact point at which radiation is delivered alone or with other cancer treatment methods mainly depends on the patient’s goals and specific type of cancer that is being treated.

When radiation therapy is given before a patient has surgery is done in hopes to shrink the tumor.   This makes it simpler for surgeons to remove the entire tumor decreasing the likelihood it will return after the surgery is complete.   Radiation that is given during surgery is known as IORT, inter-operative radiation therapy.  During surgery radiation is given when normal structures are too close to the cancerous tumor and external-beam radiation would damage the nearby normal tissues.   After surgery radiation is known as post-operative therapy.    Post-operative radiation therapy is given during complicated surgeries to regions such as the abdomen and pelvis.

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