Effect of gap length and position on results of treatment of cancer of the larynx in Scotland by radiotherapy: a linear quadratic analysis

Robertson, Anne S.; Robertson, Chris; Perone, Concetta; Clarke, K.W.; Dewar, John; Elía, M.; Hurman, David; MacDougall, R.H.; Yosef, Hosni M.A.

doi:10.1016/s0167-8140(98)00038-3

Cited by 51 publications

(31 citation statements)

References 29 publications

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“…Treatment related parameters that may have an effect on end results include overall treatment time (OTT) [6,16,27,33,40,41,42,49,51], fraction size [20,22,29,43,54] [42]. Even with surgical salvage, the group of patients whose treatment was most prolonged had an increased risk of death from loco-regional progression of disease.…”

Section: Discussionmentioning

confidence: 99%

“…40 days [49]. Gaps in treatment have a similar adverse effect [41]. It is now our policy to avoid gaps resulting from national holidays either by treating over the holiday period or delaying the start of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment methods most widely employed for T1 glottic carcinoma are radiotherapy and laser excision [41]. The latter is becoming more popular: it is more convenient for the patient than radiotherapy, but seems to be associated with a higher recurrence rate and poorer voice quality [8].…”

Section: Discussionmentioning

confidence: 99%

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Three weeks radiotherapy for T1 glottic cancer: the Christie and Royal Marsden Hospital Experience

Gowda¹,

Henk²,

Mais³

et al. 2003

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Three weeks radiotherapy for T1 glottic cancer: the Christie and Royal Marsden Hospital Experience

Gowda¹,

Henk²,

Mais³

et al. 2003

Radiotherapy and Oncology

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“…Unplanned breaks in radiotherapy for head and neck cancer are associated with significantly worse locoregional control [10,11,13]. There is evidence that even a short break may have negative conse- quences; in a retrospective analysis of 2,225 patients from four centers [11], an unplanned break of only 1 day resulted in a 0.68% lower 2-year local control rate.…”

Section: Clinical Consequences Of Radiation Treatment Breaksmentioning

confidence: 99%

Radiation Treatment Breaks and Ulcerative Mucositis in Head and Neck Cancer

et al. 2008

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Unplanned radiation treatment breaks and prolongation of the radiation treatment time are associated with lower survival and locoregional control rates when radiotherapy or concurrent chemoradiotherapy is used in the curative treatment of head and neck cancer. Treatment of head and neck cancer is intense, involving high-dose, continuous radiotherapy, and often adding chemotherapy to radiotherapy. As the intensity of treatment regimens has escalated in recent years, clinical outcomes generally have improved. However, more intensive therapy also increases the incidence of treatment-related toxicities, particularly those impacting the mucosal lining of the oral cavity, pharynx, and cervical esophagus, and results in varying degrees of ulcerative mucositis. Ulcerative mucositis is a root cause of unscheduled radiation treatment breaks, which prolongs the total radiation treatment time. Alterations in radiotherapy and chemotherapy, including the use of continuous (i.e., 7 days/week) radiotherapy to ensure constant negative proliferative pressure, may improve efficacy outcomes. However, these approaches also increase the incidence of ulcerative mucositis, thereby increasing the incidence of unplanned radiation treatment breaks. Conversely, the reduction of ulcerative mucositis to minimize unplanned breaks in radiotherapy may enhance not only tolerability, but also efficacy outcomes. Several strategies to prevent ulcerative mucositis in radiotherapy for head and neck cancer have been evaluated, but none have demonstrated strong efficacy. Continued investigation is needed to identify superior radiation treatment regimens, technology, and supportive care that reduce unplanned radiation treatment breaks with the goal of improving clinical outcomes in head and neck cancer. The Oncologist 2008;13:886 -898

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“…[49][50][51][52] In a re-analysis of data from the conventional arm of the CHART trial, 50 patients receiving radiotherapy for 49 days or more (mean 51.5 days) had an increase in relative risk of death of 19% compared with patients receiving radiotherapy for 48 days or fewer (mean 45.7 days). When adjusted for factors collected before treatment, the increase in risk of death was 9%.…”

Section: Primary Treatmentmentioning

confidence: 99%