The feasibility study on continuous 7-day-a-week external beam irradiation in locally advanced cervical cancer: a report on acute toxicity.

Abstract

To evaluate the feasibility and toxicity of continuous 7-day-a-week pelvic irradiation with no breaks between external beam irradiation and intracavitary applications. Between November 1998 and December 1999, 30 patients with FIGO Stage IIB or IIIB cervical cancer were treated with continuous 7-day-a-week pelvic irradiation, to the total Manchester point B dose of 40.0-57.6 Gy. The first 13 patients (group A) were applied a daily tumor dose of 1.6 Gy and the remaining 17 patients (group B)-10.8 Gy. One or two immediate brachytherapy applications (point A dose 10-20 Gy, each) were performed in 28 cases. Two patients did not complete the irradiation due to apparent early progression of disease during the irradiation. Of the remaining 28 evaluable patients 11 (39%) completed treatment within the prescribed overall treatment time and 17 had unplanned treatment breaks. For the latter group overall treatment time ranged from 103 to 122% (mean 114%) and from 103 to 197% (mean 138%) of the planned treatment time for group A and B, respectively. The majority of patients experienced acute toxicity. Severe toxicity (EORTC/RTOG grade 3 and 4), predominantly gastrointestinal, occurred in 5 of the 13 patients in group A, and in 7 of 17 patients in group B. The studied regimen was accompanied by considerable toxicity, hindering delivery of irradiation within planned treatment time.