Treatment breaks caused by toxicity from concurrent chemoradiation for limited small cell lung cancer decrease survival and local control

Complete prevention and rapid sustained elimination of chemoradiation toxic mucositis, a case series with implications for mucositis pathobiology, cost of care, morbidity and premature cancer deaths

“…While mucositis-mediated intestinal febrile bacteremia associated with HSCT contributes 3,412 annual deaths, the remaining 38,089 deaths arise from mucositis-dependent unplanned treatment interruptions and doses reductions lower [28,29] which unavoidably lowers the "kill dose intensity" required for optimal survival and remission. Lowered dose intensity prompts early disease recurrence and lowered 5 year survival [28,[30][31][32][33][34][35].…”

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

“…Two reports analysing the time-dose relationship for local control of disease in patients with advanced head and neck cancer treated by concomitant radio-chemotherapy delivered on alternate schedules show that it does not result in loss of local control [65,66]. In contrast, Tomiak and coworkers found an impact on survival and local control of interruptions in treatment to palliate acute morbidity of concurrent chemoradiation for limited small-cell lung cancer [67]. More clinical data are needed to study this problem in detail.…”

“…A rate of loss of survival probability with an increase in treatment duration for non-small-cell lung cancer has been calculated as being as fast as for the rate of loss of local control with treatment prolongation in head and neck cancer [36]. Much less data regarding the effect of treatment duration are available for other sites such as medulloblastoma [37,38], anal carcinoma [39][40][41][42], oesophageal cancer [43][44][45], vaginal cancer [46] or limited stage small-cell lung cancer [47,48]. In bladder cancer, the results are conflicting.…”