Importance Of Overall Treatment Time Research Articles

Outcomes After Whole-brain Radiotherapy for Brain Metastases with 5×4 Gy: Importance of Overall Treatment Time.

To investigate the impact of overall treatment time (OTT) of whole-brain radiotherapy (WBRT) with 5×4 Gy on outcomes. Forty-four patients for whom WBRT was started on a Monday (OTT=5 days) were compared to 136 patients, for whom WBRT was started on another weekday (OTT=7 days; weekend break) regarding intracerebral control and survival. Seven other factors were also analyzed. Intracerebral control at 6 and 12 months was 64% and 36% after OTT of 5 days vs. 57% and 38% after OTT of 7 days (p=0.68). On multivariate analysis, intracerebral control was positively associated with a better Eastern Cooperative Oncology Group performance score (ECOG-PS) (p<0.001). Survival at 6 and 12 months was 36% and 16% after OTT of 5 days vs. 35% and 19% after OTT of 7 days (p=0.81). On multivariate analysis, survival was positively associated with better ECOG-PS (p<0.001) and absence of extracerebral lesions (p=0.004). Prolongation of OTT to 7 days had no impact on outcomes after WBRT with 5×4 Gy.

The Importance of Overall Treatment Time in the Era of Concurrent Chemoradiation Therapy for Locally Advanced Cervical Cancer

The Importance of Overall Treatment Time in the Era of Concurrent Chemoradiation Therapy for Locally Advanced Cervical Cancer

Radiotherapy for Glottic T1N0 Carcinoma with Slight Hypofractionation and Standard Overall Treatment Time: Importance of Overall Treatment Time

We retrospectively investigated treatment outcomes in patients with glottic T1 carcinoma treated with 65 Gy in 26 fractions four times a week and discuss the importance of the overall treatment time. Two hundred one patients with glottic T1 carcinoma were evaluated. Sixty-five Gray in 26 fractions were delivered for 200 patients, whereas 1 patient received 62.5 Gy in 25 fractions. We delivered radiotherapy once daily four times a week in this period, for a weekly dose of 10 Gy. Weekdays except Wednesday were treatment days. The overall survival rate was 96.8 ± 1.3% (standard error) at 3 years and 90.8 ± 2.2% at 5 years. The local control rate was 91.9 ± 2.0% at 3 years and 89.8 ± 2.3% at 5 years. In patients with an overall treatment time equal to or longer than 47 days, the local control rate was 82.6 ± 6.0% at both 3 and 5 years. In the patients with overall treatment time equal to or less than 46 days, the local control rate was 94.6 ± 1.9% at 3 years and 91.8 ± 2.4% at 5 years. There was a significant difference between these two groups (P = 0.0349). A severe late radiation reaction occurred in one patient. He experienced severe laryngeal edema that required tracheotomy at 6 months after the completion of radiotherapy. The tracheotomy was closed at 14 months after completion of radiotherapy. Overall treatment time seems to be an important factor for a good local control rate for glottic T1N0 carcinoma even when treated with slight hypofractionation.

Importance of overall treatment time for the outcome of radiotherapy of advanced head and neck carcinoma: dependency on tumor differentiation

Purpose: Accelerated repopulation of tumor cells during radiotherapy has been suggested as an important cause of treatment failure in squamous cell carcinoma of the head and neck. Due to tumor heterogeneity, not all tumors may benefit from accelerated radiotherapy at the expense of a lower total dose. This analysis evaluates the impact of histological differentiation on loco-regional control in relation to treatment duration. Patients and methods: A total of 501 patients with advanced supraglottic and pharyngeal squamous cell carcinoma with known histopathological grading were treated with planned split-course (191 patients) or continuous radiotherapy (310 patients) in two consecutive randomized controlled trials. Irradiation was given 2 Gy per fraction, 5 fractions per week to a dose of 66–68 Gy in 9.5 or 6.5 weeks, respectively. Results: Overall, split-course and continuous treatment resulted in a 5-year loco-regional control of 30% and 41% ( P = 0.007), respectively. However, the detrimental effects of split-course were only found in moderately and well-differentiated tumors, where the 5-year tumor controls were 38% and 21% after continuous and split-course treatment, respectively ( P = 0.001). In contrast, in poorly differentiated tumors loco-regional control was obtained in 44% of the cases for continuous and 40% for split-course treatment ( P = 0.63). Conclusions: It is suggested that the ability to accelerate repopulation may be lost by dedifferentiation, and that prolongation of the overall treatment time only lead to reduced loco-regional control in well to moderately differentiated tumors.

390 The importance of overall treatment time for the outcome of radiotherapy of advanced head and neck carcinoma is dependent on tumor differentiation

Five hundred and one patients with advanced supraglottic and pharyngeal carcinoma with histopathological grading were treated with planned split-course (191 pts in the DAHANCA 2 protocol) or continuous radiotherapy (310 pts in DAHANCA 5). Irradiation were given with 2 Gy/fx, 5 fx/wk to a dose of 66–68 Gy in 91(2 or 61/2 weeks, respectively. Locoregional tumor control was significantly better in patients characterized by female sex, small T-classification, no nodes, poorly differentiated tumors and treatment given with short overall time. Overall, split-course and continuous treatment resulted in a 5-year loco-regional control of 30% and 42% (P = 0.007), respectively. However, the detrimental effect of split-course were only found in moderately and well differentiated tumors where the 5–year tumor control were 41% and 21% after continuous and split-course treatment, respectively (P = 0.0009). In contrast, poorly differentiated tumors gave tumor control values of 43% for continuous and 41% split-course treatment (P = 0.69). A Cox multivariate analysis confirmed that, among others, overall treatment time were a significant prognostic parameter in moderately and well differentiated tumors (P = 0.0002), but not in poorly differentiated (P = 0.93). It is suggested that the ability to accelerate repopulation may be lost by dedifferentiation. Supported by the Danish Cancer Society

44 The importance of overall treatment time for the outcome of radiotherapy of advanced head and neck carcinoma is dependent on tumor differentiation

44 The importance of overall treatment time for the outcome of radiotherapy of advanced head and neck carcinoma is dependent on tumor differentiation

Radiotherapy alone for carcinoma of the vagina: The importance of overall treatment time

Purpose : Review treatment results, complications, and the importance of overall treatment time for carcinoma of the vagina treated with radiotherapy alone. Methods and Materials : Between October 1964 and October 1990, 65 patients with histologically confirmed carcinoma of the vagina received definitive radiotherapy at the University of Florida. All patients had a minimum 2-year follow-up. Most patients were treated with a combination of external-beam radiotherapy and brachytherapy. The probability of pelvic control, cause-specific survival, and complications was calculated and multivariate analyses were performed. The log-rank test was used to determine significance levels between the curves. Results : The 5-year cause-specific survival rates were, Stage 0 (six patients), 100%; Stage I (17 patients), 94%; Stage IIA (six patients), 80%; Stage IIB (ten patients), 39%; Stage III (twn patients), 79%; and Stage IVA (six patients), 62%. The pelvic control rates at 5 years were: Stage 0, 100%; Stage I, 87%; Stage IIA, 88%; Stage IIB, 68%; Stage III, 80%; and Stage IVA, 67%. The parameters of stage, patient age, total dose to primary site, and overall treatment time were evaluated in a multivariate analysis. The single most important predictor of pelvic control was overall treatment time. If the entire course of radiotherapy (external beam + implant) was completed within 9 weeks (63 days), the pelvic control rate was 97%. The pelvic control rate was only 54% if treatment time extended beyond 9 weeks (p = .0003). The rate of severe complications was 12%, and the incidence increased with increasing total primary dose. Conclusion : Radiotherapy alone can cure a significant proportion of patients with carcinoma of the vagina. Treatment should be completed without significant interruption, preferably within 9 weeks.

Radiation alone for carcinoma of the vagina: The importance of overall treatment time

Radiation alone for carcinoma of the vagina: The importance of overall treatment time