Split-course radiotherapy: where do we stand?
BACKGROUND
Split-course radiotherapy is only rarely applied in curative radiotherapy and there might be a number of arguments to believe that continuous radiotherapy is superior to split-course treatment. In order to point out the evidence current treatment practice is based on, the available randomized trials and some prominent retrospective analyses on split-course radiotherapy were critically assessed.


METHODS
The analysis of the clinical results was based on published data only. Publications were searched in a Medline database.


RESULTS
Assessment of 13 randomized trials, including the data of 2,112 patients, revealed no significant difference between continuous-course and split-course radiotherapy. Astonishingly, the outcome of 77 radiotherapy studies on split-course, most of which are retrospective, seems to depend on the year of publication, suggesting publication bias.


CONCLUSIONS
No clinically relevant difference between continuous and split-course radiotherapy could be found. This, of course, does not proof that there are indeed no differences but the data do not allow to draw clear-cut conclusions in favor of or against split-course radiotherapy due to methodological shortcomings of the studies.
Dubben
H H
HH
Department of Radiotherapy and Radiooncology, University Clinics of Hamburg, Germany. dubben@uke.uni-hamburg.de
Krüll
A
A
Beck-Bornholdt
H P
HP
D019583:Dose Fractionation, Radiation; D019317:Evidence-Based Medicine; D006801:Humans; D016239:MEDLINE; D009369:Neoplasms / Q000532:radiotherapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome