Hypofractionated Radiotherapy for Advanced Non-Small-Cell Lung Cancer: Is the LINAC Half Full?
Jeffrey A. Bogart
Journal of Clinical Oncology, Vol 22, No 5 (March 1), 2004: pp. 765-768

The origin of fractionated radiotherapy dates back to observations by French investigators Regaud and Coutard, among others, during the 1920s and 1930s [1]. Before this time, there was considerable controversy regarding appropriate radiotherapy delivery, and treatment was generally administered in a single dose or in a few large fractions. Regaud documented improved tumor control of uterine carcinoma when the time of application of radium was extended to 1 week, and Coutard subsequently demonstrated that external beam therapy applied in a similar manner could cure head and neck cancer without the severe sequelae associated with single large doses [2, 3]. Consequently, fractionated treatment was widely adopted throughout Europe and North America. During the intervening years, varied regional standard treatment schemes have evolved, often guided by empiric observations and practical constraints rather than objective data. It should, therefore, not be surprising that there is little consensus regarding appropriate radiation regimens for all situations.

1. Thames HD Jr, Early fractionation methods and the origins of the NSD concept. Acta Oncol 27:89–103, 1988
2. Regaud C, Principes du traitement des épithéliomas épidermoides par les radiations. Application aux épidermoides de la peau et de la bouche. J Radiol Electrol 7:297, 1927
3. Coutard H, Principles of x-ray therapy of malignant disease. Lancet 2:1, 1934
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