title: Split-course radiotherapy: where do we stand?
abstract: BACKGROUND
  Split-course radiotherapy is only rarely applied in curative radiotherapy and there might be a number of arguments to believe that continuous radiotherapy is superior to split-course treatment. In order to point out the evidence current treatment practice is based on, the available randomized trials and some prominent retrospective analyses on split-course radiotherapy were critically assessed.
  
  
  METHODS
  The analysis of the clinical results was based on published data only. Publications were searched in a Medline database.
  
  
  RESULTS
  Assessment of 13 randomized trials, including the data of 2,112 patients, revealed no significant difference between continuous-course and split-course radiotherapy. Astonishingly, the outcome of 77 radiotherapy studies on split-course, most of which are retrospective, seems to depend on the year of publication, suggesting publication bias.
  
  
  CONCLUSIONS
  No clinically relevant difference between continuous and split-course radiotherapy could be found. This, of course, does not proof that there are indeed no differences but the data do not allow to draw clear-cut conclusions in favor of or against split-course radiotherapy due to methodological shortcomings of the studies.
authors.affiliation: Department of Radiotherapy and Radiooncology, University Clinics of Hamburg, Germany. dubben@uke.uni-hamburg.de
authors.forename: H H
authors.initials: HH
authors.lastname: Dubben
authors.forename: A
authors.initials: A
authors.lastname: Krüll
authors.forename: H P
authors.initials: HP
authors.lastname: Beck-Bornholdt
mesh_terms: D019583:Dose Fractionation, Radiation; D019317:Evidence-Based Medicine; D006801:Humans; D016239:MEDLINE; D009369:Neoplasms / Q000532:radiotherapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome