Based on promising preclinical data, clinical studies have been performed in a variety of cancer types with LDFRT in addition to standard chemotherapy. Investigators at the University of Kentucky published their experience using carboplatin and paclitaxel with 4 fractions of 0.8 Gy each in locally advanced head and neck cancer patients. They observed toxicities similar to those expected from chemotherapy alone and concluded that the addition of LDFRT was "extremely well tolerated." Moreover, they reported excellent response rates. Regine et al. conducted a phase I trial of low dose abdominal RT (0.6 vs. 0.7 Gy fractions, total 8 fractions) and gemcitabine 1,250 mg/m2 among patients with unresectable pancreatic/small bowel carcinomas. The authors concluded that abdominal LDFRT using 0.6 Gy fractions was well tolerated when given concurrently with full-dose gemcitabine. A multi-institutional phase II trial using this regimen suggested improved efficacy of the combined regimen in improving overall survival. Sixty-one percent of enrolled patients experienced at least stable disease, and median survival in this poor prognosis population was 13 months. More importantly, no additional toxicity was observed with LDFRT other than that expected from the high dose of gemcitabine (personal communication, manuscript in preparation). More recently, Wrenn et al. demonstrated tolerability of concomitant low-dose whole-abdominal RT and full-dose cisplatin in optimally debulked stage III/IV endometrial cancer patients.