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Improving the Results of RT
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PROBLEMS
1. Inadequate dose delivered so poor efficacy despite the
fact that it was known that dose escalation beneficial –
calculated that increasing the dose of radiation by 10%
can increase local control by 20%
2. Inability to dose escalate without unacceptable toxicity
to surrounding normal structures
3. High risk disease also recurrence at nodal and distant
sites
IMRT: intensity-modulated RT
HDR: high dose rate