Synopsis
Explain curative and palliative radiotherapy, connect target definition and fractionation to tumour control and normal-tissue risk, and recognise urgent, acute and late radiation toxicity.
- Radiotherapy deposits ionising energy that damages DNA directly and through free radicals; fractionation allows normal-tissue repair while repeated exposure accumulates tumour effect.
- Treatment may be definitive, neoadjuvant, adjuvant, consolidative or palliative and can use external beam, stereotactic techniques or brachytherapy.
- CT simulation, immobilisation, target and organ-at-risk contouring, dose planning and independent checks precede the first fraction.
Key red flags
Cord compression, airway compromise or cerebral oedema requires urgent multidisciplinary rescue; radiotherapy planning must not delay immediate stabilisation.
Investigation priorities
Create the reproducible geometry used for target and organ contouring.
Management branches
Radiotherapy is proposed after diagnosis and staging.
- Agree curative or palliative intent, alternatives and the evidence-based dose-fractionation option at MDT and consultation.
- Complete simulation, immobilisation and image fusion, then contour targets and organs at risk using tumour-specific standards.