ASSIGNMENT

SUBMITTED BY: NIMRA IRAM

ROLL #: F20BPHYS3E01030
SUBMITTED TO: DR. SAEED AHMAD BUZDAAR
SUBJECT: RESEARCH METHODOLOGY LAB
TOPIC: PRACTICE OF D/F REFERENCE STYLES
PROGRAM: M.PHILL PHYSICS

The Four R's of Radiotherapy

1: Numbered Reference Style
Radiotherapy given as multiple doses are effective in sterilizing cancers, but the
processes whereby the neoplasm is eradicated and the normal tissues are preserved
are not fully understood. The differential between normal tissue and tumor response is
enhanced by dose fractionation, single doses resulting in severe normal tissue injury
when the dose is sufficient to control a proportion of treated tumors. This chapter
focuses on the four Rs that influence the outcome of fractionated-dose radiotherapy,
one or more of which may account for the relative sparing of normal tissues. These are
repair of sublethal injury in normal and neoplastic cells, reoxygenation of the tumor,
redistribution through the division cycle, and regeneration of surviving normal and
malignant cells between dose fractions. These have been called the four Rs of
fractionated radiotherapy. Other factors are involved in the outcome of multifraction
radiotherapy—for example, the maintenance of the architectural integrity of the normal
tissues, the volume of tissue irradiated, the tumor bed, and the immunocompetence of
the host are some other factors that play a significant role in the differential response.[1]

1. Withers, H.R., The four R's of radiotherapy, in Advances in radiation biology. 1975, Elsevier. p.
241-271.