<unk>  for a patient with a diffuse intrinsic pontine glioma, with<unk>  dose color-coded. Different cancers respond to<unk>  in different ways. The response of a cancer to<unk>  is described by its radiosensitivity. Highly radiosensitive cancer cells are rapidly killed by modest doses of<unk> . These include leukemias, most lymphomas and germ cell tumors. The majority of epithelial cancers are only moderately radiosensitive, and require a significantly higher dose of<unk>  (60-70 Gy) to achieve a radical cure. Some types of cancer are notably radioresistant, that is, much higher doses are required to produce a radical cure than may be safe in clinical practice. Renal cell cancer and melanoma are generally considered to be radioresistant but<unk>  is still a palliative option for many patients with metastatic melanoma. Combining<unk>  with immunotherapy is an active area of investigation and has shown some promise for melanoma and other cancers. It is important to distinguish the radiosensitivity of a particular tumor, which to some extent is a laboratory measure, from the<unk>  "curability" of a cancer in actual clinical practice. For example, leukemias are not generally curable with<unk> , because they are disseminated through the body. Lymphoma may be radically curable if it is localised to one area of the body. Similarly, many of the common, moderately radioresponsive tumors are routinely treated with curative doses of<unk>  if they are at an early stage. For example, non-melanoma skin cancer, head and neck cancer, breast cancer, non-small cell lung cancer, cervical cancer, anal cancer, and prostate cancer. Metastatic cancers are generally incurable with<unk>  because it is not possible to treat the whole body. Before treatment, a CT scan is often performed to identify the tumor and surrounding normal structures. The patient receives small skin marks to guide the placement of treatment fields. Patient positioning is crucial at this stage as the patient will have to be placed in an identical position during each treatment. Many patient positioning devices have been developed for this purpose, including masks and cushions which can be molded to the patient. The response of a tumor to<unk>  is also related to its size. Due to complex radiobiology, very large tumors respond less well to<unk>  than smaller tumors or microscopic disease. Various strategies are used to overcome this effect. The most common technique is surgical resection prior to<unk> . This is most commonly seen in the treatment of breast cancer with wide local excision or mastectomy followed by adjuvant<unk> . Another method is to shrink the tumor with neoadjuvant chemotherapy prior to radical<unk> . A third technique is to enhance the radiosensitivity of the cancer by giving certain drugs during a course of<unk> . Examples of radiosensitizing drugs include Cisplatin, Nimorazole, and Cetuximab. The impact of radiotherapy varies between different types of cancer and different groups. For example, for breast cancer after breast-conserving surgery, radiotherapy has been found to halve the rate at which the disease recurs.
Radiation therapy
Chemoradiotherapy
Irradiation
External beam radiotherapy
Stereotactic radiation therapy
Plaque radiotherapy
Chemotherapy
Tomotherapy