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

Purpose: To evaluate the feasibility and toxicity of continuous 7-day-a-wee k pelvic irradiation with no breaks between external beam irradiation and i ntracavitary applications. Material and methods: 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 o f 1.6 Gy and the remaining 17 patients (group B)-10.8 Gy. One or two immedi ate brachytherapy applications (point A dose 10-20 Gy, each) were performed in 28 cases. Results: Two patients did not complete the irradiation due to apparent earl y progression of disease during the irradiation. Of the remaining 28 evalua ble patients 11 (39%) completed treatment within the prescribed overall tre atment time and 17 had unplanned treatment breaks. For the latter group ove rall 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 (EOR TC/RTOG grade 3 and 4), predominantly gastrointestinal, occurred in 5 of th e 13 patients in group A, and in 7 of 17 patients in group B. Conclusion: The studied regimen was accompanied by considerable toxicity, h indering delivery of irradiation within planned treatment time. (C) 2001 Pu blished by Elsevier Science Ireland Ltd.