This is Episode 19: Altered Fractionation - Hyperfractionation, Accelerated Radiotherapy, and CHART.In our previous episode, we mastered the Linear-Quadratic model and the concept of Biological Effective Dose, tools that allow us to compare different radiation schedules. We learned that early and late-responding tissues, as well as tumors, have different sensitivities to changes in fraction size, largely dictated by their α/β ratios. Today, we're going to build directly on that knowledge by exploring how these principles are applied to design altered fractionation schedules. We’ll unpack strategies like hyperfractionation, designed to spare late normal tissue effects, and accelerated radiotherapy, aimed at combating tumor repopulation. We'll also discuss the critical importance of the time between fractions in multi-fraction-per-day regimens and look at a famous example of combining these concepts in the CHART protocol.

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