Radiotherapy dose fractionation, third edition

Date of next review: 

Please note: Radiotherapy Dose Fractionation Third Edition and Timely Delivery of Radical Radiotherapy: guidelines for the management of unscheduled treatment interruptions, fourth edition are both currently under review and due to be published later in 2023. You should therefore refer to the Bladder Consensus Statements for the latest guidance on radical and palliative fractionation schedules for bladder cancer, and how treatment interruptions should be managed in the bladder cancer patient (i.e. bladder cancer should be treated as a Category 1 tumour).

Radiotherapy Dose Fractionation Third Edition aims to recommend evidence-based radiotherapy treatment regimens and fractionation schedules and to present acceptable treatment options ranked according to the level of evidence available. 

The first edition of Radiotherapy Dose Fractionation presented guidelines derived from a rigorous appraisal of the literature published by June 2006. In December 2016 a second edition was published to reflect changes in practice which had evolved in the previous decade.

The RCR’s Clinical Oncology Professional Support and Standards Board review all RCR publications on a regular basis to ensure they remain up to date. This third edition has therefore been produced to take account of further published evidence.

This third edition replaces the previous second edition which has now been withdrawn.

For ease of use, the document can be downloaded by chapter or as a single pdf.

Change log

20 November 2020

Head and neck chapter - page 44 - Palliative radiotherapy recommendations box

Second schedule updated to 8 Gy in 3 fractions over 3 weeks (Level C) 

Original schedule incorrectly stated 21 Gy in 3 fractions over 3 weeks (Level C)

2 December 2020
02 December 2020 Head and neck chapter – Page 44 

Palliative radiotherapy schedules recommendations box 

Second schedule updated to 24 Gy in 3 fractions over 3 weeks (Level C) 

Previous iteration (in place 20 November 2020 until 02 December 2020) stated 8 Gy in 3 fractions over 3 weeks (Level C)