Carcinoma of the uterine cervix. II. Lack of impact of prolongation of overall treatment time on morbidity of radiation therapy

Cervical Cancer

“…[133][134][135][136][137][138] Although debate remains about whether an increase in treatment duration adversely affects outcome or is simply a reflection of unfavorable tumor or patient characteristics or whether this pertains to patients treated with chemoradiation, there is compelling radiobiologic demonstration of accelerated tumor repopulation that mitigates the efficacy of RT. There is general consensus that prolonging a course of radical RT beyond approximately 7 weeks is associated with a 0.5% to 1% decrease in pelvic control per extra day.…”

“…There is general consensus that prolonging a course of radical RT beyond approximately 7 weeks is associated with a 0.5% to 1% decrease in pelvic control per extra day. 138 Therefore, it is now considered prudent to complete a course of definitive RT for cervical cancer within 7 weeks to 8 weeks by eliminating all elective treatment breaks, delivering EBRT parametrial boosts between, or interdigitated with, brachytherapy insertions, and actively supporting patients through acute toxicities so as to avoid RT interruptions. 139 In contrast, there is no evidence that prolongation of treatment duration results in a reduction of late normal tissue sequelae.…”