9.4 - Altered Fractionation In The Department

Under what circumstances will patients not receive the standard 1 fraction per weekday?

This occurs under several circumstances:

  • Some curative treatments require twice daily treatments (eg. small cell lung cancer)
  • Patients who become unwell and miss treatments may need to catch up on treatments (eg. head and neck cancer delayed by sepsis or surgery)
  • Occasionally patients may require a treatment break
  • Linear accelerators need to be serviced; often patients with cancers that have not demonstrated significant accelerated repopulation may receive 9 fractions per fortnight, allowing the linear accelerator to be serviced on the remaining day
  • Palliative treatments may be given with a hypofractionated schedule. An example is 'quad shots', which is four fractions delivered over 2 days, with a break of one month between treatments