title: The effect of overall treatment time on the survival and toxicity of radical radiotherapy for cervical carcinoma.
abstract: OBJECTIVE
  Overall treatment time is an important factor in the outcome of radical radiotherapy in head and neck, bladder and lung cancer and in cervix cancer treated over more than 7 weeks. This study analysed the effect of prolongation of overall treatment time on survival and late morbidity for patients receiving radical radiotherapy for cervical cancer treated with a 4-week regimen.
  
  
  METHODS
  Using the departmental SAS data-base we identified all patients with cervix cancer treated between 1974 and 1988 and investigated the 647 patients who received 20 fractions of external beam radiotherapy plus intracavitary therapy with a total dose to point A of at least 60Gy. A retrospective case-note review identified tumour and treatment-related variables.
  
  
  RESULTS
  Four hundred and twenty-five (66%) patients had at least one gap in treatment. Seventy-nine gaps (11%) were due to unavoidable patient or treatment-related causes. We could not find an effect of a treatment gap (P=0.43) or an increased overall treatment time (P=0.79) on the cause specific survival of patients. There was significantly more grade 4 morbidity in those patients treated over a short period (29-32 days) compared to the rest (P=0.005), possibly related to the loss of radiotherapy-free days to weekend intracavitary insertions.
  
  
  CONCLUSIONS
  We could not demonstrate a significant effect of overall treatment time in this series of patients, almost all of whom were treated in less than 7 weeks. Those patients treated over the shortest period had an increased incidence of late morbidity.
authors.affiliation: Department of Oncology, Western General Hospital, University of Edinburgh, Crewe Road, Edinburgh, UK.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Erridge
authors.forename: Gillian R
authors.initials: GR
authors.lastname: Kerr
authors.forename: Darren
authors.initials: D
authors.lastname: Downing
authors.forename: William
authors.initials: W
authors.lastname: Duncan
authors.forename: Allan
authors.initials: A
authors.lastname: Price
mesh_terms: D000328:Adult; D000368:Aged; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009017:Morbidity; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*