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Primary radiation therapy for the oral cavity

Implementation

Dose and fractionation

Patients are treated with photons, but sometimes in combination with electrons . The dose rate should be between 0.5 and 5 Gy per minute. A homogeneous dose should always be striven for, possibly with use of a compensation dose.

It is important to maintain the planned treatment schedule.

Standard treatment

All fields are treated at each fractionation.

  • 46 Gy to union of all ITV (=CTV)

  • 70 Gy to union of all GTV (concomitant boost, 6 fx/week)
  • 6 fractionations per week  
  • 1 fraction daily, Monday-Friday
  • The 6th fractionation is given additionally on one of the week's first 5 days, but always with a 6 hour interval. 

Unforeseeable interruptions

Not more than one extra fractionation per week is the goal, and missed sessions should be given within one week. This is done by giving an extra fractionation on the weekend, or the same day as the planned fractionation with ≥ 6 hours interval.

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