16
- Postoperative adjuvant CRT (MacDonald regime):
RT dose fractionation: 45 Gy in 25 fractions of 1.8 Gy.
Adjuvant chemotherapy: 5FU and leucovorin every 4 weeks
for five cycles with RT concurrent with the second and
third cycles.
Cycle 1, 4, 5: 5FU (425 mg/m^2 /day) and leucovorin (20 mg/
m^2 /day) for 5 days.
Cycle 2, 3 (concurrent with RT): 5FU (400 mg/m^2 /day) and
leucovorin (20 mg/m^2 /day) on the first 4 days and last
3 days of RT. - Palliative RT:
Suggested dose fractionation for external RT: 30 Gy in ten
fractions for RT alone or 50 Gy in 25 fractions if given
with concurrent chemotherapy.
Brachytherapy: 6 Gy for three fractions or 8 Gy for two frac-
tions at 1 cm from the center of the source axis. 8 Gy for
two fractions or 4 Gy for five fractions can be given before
external RT. Brachytherapy should not be given concur-
rent with external RT or chemotherapy.
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