• External beam radiotherapy
• Brachytherapy

• Radiation is generated from outside the patient body and is targeted at the tumor site.

• In this treatment, radioactive source is placed in or near the tumor itself.

• Conventional 2D radiotherapy
• 3 D conformal radiotherapy
• Intensity modulated radiotherapy (IMRT)
• Image guided radiotherapy (IGRT)
• Adaptive radiotherapy
• 4-dimensional radiotherapy (4D-RT)
• Stereotactic radiotherapy
• Stereotactic body radiotherapy
• Electron beam radiotherapy

Two-dimensional (2D) radiotherapy consisted of a single radiation beam from one to four directions.

This treatment beam shapes the radiation beams to match the shape of the tumor.

This is advanced form of conformal radiotherapy. This technique shapes the radiation beams to closely fit the area of the cancer.

Image guided radiotherapy uses X-rays and scans similar to CT scans before and during radiotherapy treatment.

During a course of radiotherapy treatment a tumour may shrink or change shape. Adaptive radiotherapy means changing the radiotherapy according to these changes.

It delivers precisely-targeted radiation in fewer high-dose treatments than conventional therapy to brain.

Stereotactic Body Radiation Therapy (SBRT) is a treatment procedure similar to central nervous system (CNS) stereotactic radiotherapy, except that it deals with other parts of body.

Electrons are used for treatment of superficial tumors.

This treatment uses highly conformal image guided technique for treatment.

• Stage IB2 onwards radiotherapy is used as main modality of treatment. In this radiotherapy treatment, both external and internal radiotherapy are used.
• In advanced cases, if surgery is done then post op radiotherapy is delivered in most cases.

• After surgery radiotherapy is delivered as adjuvant treatment.

• After breast conservation surgery , radiotherapy is must. After mastectomy radiation is delivered in advanced cases.

• Carcinoma oropharynx, nasopharynx, laryngopharynx radiation is delivered as main modality of treatment. Carcinoma oral cavity , it is used as sole treatment if disease is very small and in advanced cases it is used after surgery.

In early stages, stereotactic body radiotherapy is used as treatment. In advanced cases concurrent radio chemotherapy is used as treatment.

All types of brain malignancies are treated with radiotherapy after surgery.

In cervical esophagus, radiotherapy is used as sole modality of treatment. In middle or lower esophagus, radiotherapy is used either before surgery or after surgery.

• Gastric cancer
• Sarcoma
• Skin cancer
• Nasal cavity and sinus cancer
• Prostate cancer
• Carcinoma vagina
• Carcinoma vulva
• Pancreatic cancer
• Carcinoma rectum
• Carcinoma anal canal

During radiotherapy of GI malignancies motion of tumor, tumor bed and normal structures is a big challenge. With the help of modern image guided techniques treatment accuracy has been improved.

These techniques have the potential to improve radiation treatment by conforming the radiation dose tightly to the tumor while sparing normal tissues.

Stereotactic body radiotherapy is a type of external beam radiotherapy that delivers ablative high doses of radiation.It is now strongly recommended for treatment of hepatocellular carcinoma also an alternative to ablative and embolization techniques.

Intraluminal brachytherapy in cholangicarcinoma plays an important role.