[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-515743-105":59,"doc-detail-515743-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","clinical-oncology-radiotherapy-dose-fractionation-fourth-edition","Clinical Oncology Radiotherapy dose fractionation - Fourth edition","","Guidance addresses radiotherapy dose fractionation in the context of varied UK clinical practice, describing how subsequent editions increased standardisation through evidence-based approaches, clinical trials, and guideline-driven organisation of cancer care. It emphasizes that the radiotherapy treatment prescription must be complete, documenting patient identification, diagnosis, targeted anatomy and laterality, prescriber identity, intent, prescription completion date, modality, volumes, absorbed dose and dose-volume requirements for PTV, fractionation scheme, normal tissue constraints, overall treatment time, and technical parameters, including related treatment requirements.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinical-oncology-radiotherapy-dose-fractionation-fourth-edition/515743/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinical-oncology-radiotherapy-dose-fractionation-fourth-edition/515743.png","ImageObject",300,407,{"name":92,"@type":93},"eBook King","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-10-06",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is standardisation of radiotherapy dose fractionation emphasized since the first edition?","Question",{"text":112,"@type":113},"It reflects growing evidence-based practice, wider involvement in clinical trials on fractionation, and organised cancer care aligned with local and national guidelines.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What elements should the radiotherapy treatment prescription document?",{"text":117,"@type":113},"It should include unique patient identification, diagnosis, target anatomical region with laterality, prescriber identity, intent, completion date, modality, volume definitions, PTV absorbed dose and/or dose-volume requirements, fractionation scheme, normal tissue constraints, overall treatment time, and relevant technical details and associated treatments.",{"name":119,"@type":110,"acceptedAnswer":120},"How do the guidelines handle advanced techniques like IMRT, IGRT, VMAT, and SBRT?",{"text":121,"@type":113},"They acknowledge that, despite adoption and efforts to redefine fractionation over the past decade, many clinical scenarios—especially palliative treatments—still require conventional therapy techniques.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},515743,1791399080,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962088006270,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Clinical Oncology Radiotherapy dose fractionation Fourth edition  \nJANUARY 2024  \nContents  \nIntroduction 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 3 01 Anal cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 7 02 Bladder cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 10 03 Breast cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 15 04 Central nervous system (CNS) tumours 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 27 05 Gastro-oesophageal cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 40 06 Gynaecological cancers 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 48 07 Head and neck cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 56 08 Hepato-pancreato-biliary cancer (HPB) 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 66 09 Lung cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 79 10 Lymphoma 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 90 11 Paediatric cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 100 12 Penile cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 116 13 Prostate cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 120 14 Rectal cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 128 15 Renal cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 135 16 Sarcoma 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 139 17 Seminoma 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 148 18 Skin cancer 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 151 19 Bone metastases 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 162 20 Brain metastases 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 166 21 Extracranial oligometastases 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 172 22 Metastatic spinal cord compression (MSCC) 􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮􀀮 179  \nIntroduction  \nThe original guidance on Radiotherapy dose fractionation was introduced against a background of considerable variation in clinical practice across the UK.  \nSince that 2006 first edition there has been greater standardisation of treatment reflecting many influences, including more widespread appreciation of evidence-based practice, nationwide involvement in clinical trials addressing fractionation questions within the National Cancer Research Network and National Institute for Health Research, and organisation of cancer care within networks charged with adherence to local and national guidelines.  \nThe legal record of the radiotherapy treatment to be delivered is the radiotherapy treatment prescription. Since the radiotherapy prescription is frequently used by clinical providers as evidence that the justification of treatment – and sometimes the verification of exposures – has been completed, all radiotherapy prescriptions should be as complete as possible. These should include: unique patient identification; diagnosis; anatomical region to be treated including laterality; identity of the prescribing practitioner; treatment intent; date the prescription was completed (written); modality; definition of volumes; specification of absorbed dose and/or dose-volume requirements for the planning target volume (PTV); fractionation scheme; normal tissue constraints; overall treatment time; physical technique, energy and, where relevant, absorbed dose-distribution(s) planned and details of anyother associated treatment requirements, for example chemotherapy, cardiac implantable electronic devices (CIED), prostheses. The record of the prescription may be represented asa single document or a collection of data items across the oncology management system and treatment planning system.  \nIt has been important to recognise that, despite adoption of intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), volumetric modulated arc radiotherapy (VMAT) and stereotactic body radiotherapy (SBRT) with changes to redefine fractionation during the past decade, many clinical scenarios, particularly for palli","cbCaiq1311ka6okA","https://ap.wps.com/l/cbCaiq1311ka6okA","pdf",1502180,184,"English","# Introduction\n## Radiotherapy treatment prescription completeness\n## Standardisation and evidence-based practice\n## Conventional techniques alongside IMRT/IGRT/VMAT/SBRT\n## Evidence grading (Oxford Centre for Evidence-Based Medicine)\n## Grades of recommendation and levels of evidence","[{\"question\":\"Why is standardisation of radiotherapy dose fractionation emphasized since the first edition?\",\"answer\":\"It reflects growing evidence-based practice, wider involvement in clinical trials on fractionation, and organised cancer care aligned with local and national guidelines.\"},{\"question\":\"What elements should the radiotherapy treatment prescription document?\",\"answer\":\"It should include unique patient identification, diagnosis, target anatomical region with laterality, prescriber identity, intent, completion date, modality, volume definitions, PTV absorbed dose and/or dose-volume requirements, fractionation scheme, normal tissue constraints, overall treatment time, and relevant technical details and associated treatments.\"},{\"question\":\"How do the guidelines handle advanced techniques like IMRT, IGRT, VMAT, and SBRT?\",\"answer\":\"They acknowledge that, despite adoption and efforts to redefine fractionation over the past decade, many clinical scenarios—especially palliative treatments—still require conventional therapy techniques.\"}]","Clinical Oncology Radiotherapy dose fractionation - Fourth edition | PDF",1791321687,464]