Compliance to the prescribed overall treatment time (OTT) of curative radiotherapy in normal clinical practice and impact on treatment duration of counteracting short interruptions by treating patients on Saturdays

Garau, Miquel Macià i; Monné, Josep Solé; Serés, Maria José Cambra; Binefa, Carlota Monfà; Llopis, Maribel Peraire

doi:10.1007/s12094-009-0358-2

Cited by 17 publications

(6 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Out of the 75 patients, only 1.3% received <95% of the prescribed radiation dose; the dose administered to neck volumes represented 98.4% of the prescribed dose (nodal CTV1: 99.6%, nodal CTV2: 98%), 90.6% completed their radiation therapy plan with no more than one day of interruption, and all completed the plan with less than six days of interruption; only 3.5% of interruptions were secondary to toxicity, a lower percentage than in previous reports [24,25]. In the study based on SEER’s (Surveillance, Epidemiology and End Results) [26] database, which included 5,086 patients with head-and-neck cancer, 29.6% of the patients treated with surgery and radiotherapy showed treatment discontinuity and/or non-adherence (33.3% of those with oral cancer and 33.5% of those with oropharyngeal cancer).…”

Section: Discussionmentioning

confidence: 68%

Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study

et al. 2013

View full text Add to dashboard Cite

BackgroundIn cervical postoperative radiotherapy, the target volume is usually the same as the extension of the previous dissection. We evaluated a protocol of selective irradiation according to the risk estimated for each dissected lymph node level.MethodsEighty patients with oral/oropharyngeal cancer were included in this prospective clinical study between 2005 and 2008. Patients underwent surgery of the primary tumor and cervical dissection, with identification of positive nodal levels, followed by selective postoperative radiotherapy. Three types of selective nodal clinical target volume (CTV) were defined: CTV0, CTV1, and CTV2, with a subclinical disease risk of <10%, 10-25%, and 25% and a prescribed radiation dose of <35 Gy, 50 Gy, and 66–70 Gy, respectively. The localization of node failure was categorized as field, marginal, or outside the irradiated field.ResultsA consistent pattern of cervical infiltration was observed in 97% of positive dissections. Lymph node failure occurred within a high-risk irradiated area (CTV1-CTV2) in 12 patients, marginal area (CTV1/CTVO) in 1 patient, and non-irradiated low-risk area (CTV0) in 2 patients. The volume of selective lymph node irradiation was below the standard radiation volume in 33 patients (mean of 118.6 cc per patient). This decrease in irradiated volume was associated with greater treatment compliance and reduced secondary toxicity. The three-year actuarial nodal control rate was 80%.ConclusionThis selective postoperative neck irradiation protocol was associated with a similar failure pattern to that observed after standard neck irradiation and achieved a significant reduction in target volume and secondary toxicity.

show abstract

Section: Discussionmentioning

confidence: 68%

Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Such interruptions to the radiotherapy schedule and the associated prolonged overall treatment times can result in loss of local tumor control and an increased risk of tumor repopulation. This phenomenon has been well documented in patients with squamous cell carcinoma of the head and neck, as well as in other cancers 8,11–14. The repopulation rate during a treatment gap was estimated to be nearly four times faster than that during irradiation days 15,16.…”

Section: Introductionmentioning

confidence: 79%

“…In a survey in a radiation oncology department, 39% of patients reported that their pain was inadequately treated 6,7. Such poor pain control has been reported to impact a patient’s willingness to attend treatment and to affect their ability to complete a course of treatment without interruptions, which in turn would impact the potential benefits of radiotherapy 8,10–13,15–17,27…”

Section: Conclusion and Potential Implicationsmentioning

confidence: 99%

“…This situation may increase a patient’s anxiety and cause them to hesitate, reschedule, or decline radiotherapy treatment. Reasons for radiotherapy treatment interruptions have been poorly described in the literature, perhaps reflecting a lack of awareness of the importance of avoiding interruptions 8. One reason that has been reported for treatment interruptions is an inability to withstand the acute side effects of radiotherapy 9,10.…”

Section: Introductionmentioning

confidence: 99%

“…The repopulation rate during a treatment gap was estimated to be nearly four times faster than that during irradiation days 15,16. One extra day of prolonged treatment of radiotherapy was estimated to reduce local control by 1.4% to 1.7% each day 8,17. In another study, each day of interruption of radiotherapy was estimated to increase the hazard rate by 3.3% for local and regional tumor control, and by 2.9% for disease-free survival 10…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy

Bell¹,

Butler²

2013

JPR

View full text Add to dashboard Cite

BackgroundStudies report the need for improved pain management in the radiation oncology setting. Many patients with well controlled background pain experience breakthrough pain in cancer (BTPc) that can interrupt their treatment schedule with a potentially negative impact on outcomes. BTPc can be unpredictable and predictable; both types of pain can be managed with fast-acting analgesics, but predictable pain lends itself to anticipatory management.MethodsFive consecutive cases are described in which fentanyl pectin nasal spray (FPNS) was used to manage BTPc, with an emphasis on the anticipatory management of predictable pain in cancer patients receiving radiotherapy.ResultsPatients (four men, one woman), age range 32–84 years, were diagnosed with various cancers. All patients were receiving opioid treatment for chronic pain, and experienced predictable pain with radiotherapy which included pain associated with lying on a treatment table for a sustained time during an average of 29 radiotherapy treatments; pain associated with radiation simulation and radiotherapy; pain associated with odynophagia related to increasing mucositis during treatment, resulting in decreased nutritional intake; pain associated with the customized immobilization mask for head and neck cancer patients; and pain associated with defecation. Some patients also reported pain awakening them randomly at night (eg, sleep interruption). All patients attained lower pain intensity scores (2/10 to 3/10), reduced from approximately 7/10, when they were treated with FPNS 20 minutes before a predictable pain event. No patient experienced any pain-related interruptions to their course of radiotherapy. The average number of radiotherapy sessions was 29 per patient, excluding one short-course treatment for one patient.ConclusionFPNS offers a good solution to the management of BTPc because its fast onset of action makes it very suitable for the anticipatory treatment of predictable pain, which is likely to minimize interruptions to the radiotherapy schedule.

show abstract

Correlation of radiation treatment interruptions with psychiatric disease and performance status in head and neck cancer patients

Sreeraman

Vijayakumar

Chen

2013

Support Care Cancer

View full text Add to dashboard Cite

show abstract

Compliance to the prescribed overall treatment time (OTT) of curative radiotherapy in normal clinical practice and impact on treatment duration of counteracting short interruptions by treating patients on Saturdays

Cited by 17 publications

References 63 publications

Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study

Selective use of postoperative neck radiotherapy in oral cavity and oropharynx cancer: a prospective clinical study

Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy

Correlation of radiation treatment interruptions with psychiatric disease and performance status in head and neck cancer patients

Contact Info

Product

Resources

About