Clinical Experience Shows That Catastrophic Late Effects Associated With Ablative Fractionation Can Be Avoided by Technological Innovation

The development of high-precision radiation therapy delivery technology has expedited a burgeoning interest in ultrabrief, intensified treatment courses that yield tumoricidal effects of unprecedented potency. Whereas novel medical treatments that provide enhanced clinical benefits can be associated with escalated risks of toxicity, it is absolutely essential for radiation oncologists to exercise caution and discipline as these new strategies are evaluated and implemented in the clinic. However, it is argued here that clinical experiences reported to date already support the durable safety and efficacy of so-called “ablative” schedules of radiation therapy. Furthermore, until the cancer problem is solved once and for all, it is the obligation of the radiation oncology community to continue to pursue new means to improve on results of the past.