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Rationale for chemo-radiation
1. Additive effects
- Enhanced cell death through cytotoxic DNA cross-links
2. Synergistic effects
- Inhibition of repair of radiation induced damage
- Promote synchronization of cells into a radiosensitive phase
- Initiating proliferation in non-proliferating cells
- Hypoxic cell sensitization and reducing fraction of hypoxic cells
3. Independent effect
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CT may independently increase the rate of death of tumour cells