HN2.gif (36392 bytes) Common Radiation Protocols

More detailed information about each site, type of cancer, with treatment details and results can be found in the cancer section.

For a general overview of the dose schemes see below:
Bone Metastases: the most common dose is 3000cGin 10 treatments of 300cGy over a two week period. For patients with a large destructive lesion of a met to the spine, we sometimes go slower and to a higher dose (e.g. 4000cGy in 20 treatments of 200cGy over a four week period.

Brain Metastases: for patients with multiple brain metastases the most common protocol is to treat the whole brain to 3000cGy in 10 treatments of 300. For patients with 1 to 3 smaller lesions more aggressive approaches such as surgery or gamma knife treatment may be considered

Brain Tumors: for glioblastoma the usual dose is 5940cGy in 33 fractions of 180cGy or 6000cGy in 30 fractions. Low grade gliomas generally get a slightly lower dose (5400cGy.)

Breast Cancer: the most common regimen is to treat the entire breast to 4680cGy in 26 fractions of 180cGy then boost the lumpectomy site with electrons an additional 1200-1400cGy at 200cGy per fractions

Colon/Rectum: the usual dose if 5040cGy in 28 fractions to the pelvis from four directions either before or after surgery. The radiation is usually combined with 5-FU chemotherapy

Endometrial (Uterus): the usually postoperative dose if 4500 - 5040cGy in 28 fractions of 180cGy over 5 weeks. Some patients also receive HDR treatment (500cGy X 3) or may be treated entirely by HDR (500cGy X 5.)

Esophagus: Most patients now are treated with combined radiation/chemotherapy. The radiation dose is generally 5040cGy - 5940cGy at 180cGy per fraction.

Head & Neck: for early lesions, radiation alone 6600 - 7000cGy at 200cGy per fractions is common. For advanced disease this is combined with chemotherapy (e.g. Carboplatin/Taxol.) For postOp radiation the usual dose is 5940 to 6600cGy at 180cGy per fraction.

Lung: most patients now receive concurrent chemotherapy (for small cell or non-small cell.) The usual radiation dose is 5940 to 6600 at 180-200cGy per fraction.

Pancreas: radiation is usually combined with chemotherapy (5-FU or Gemzar) and the dose is 6000cGy at 200cGy per fraction.

Prostate: for external beam alone the usual dose is 7500cGy at 180cGy per fraction for 40 treatments over 8 weeks. For combination we usually treat with external beam first (4500cGy at 180cGy) followed by an attenuated dose seed implant (11,500cGy for I-125 or 10,000cGy for Pd-103.)

Skin: for small lesions 5100cGy at 300cGy in 17 fractions; for intermediate lesions 5500cGy at 250cGy in 22 fractions, for large lesions or very delicate skin 6000cGy at 200cGy in 30 fractions over 6weeks.

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