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Article: The effect of interruptions and prolonged treatment time in radiotherapy for nasopharyngeal carcinoma

TitleThe effect of interruptions and prolonged treatment time in radiotherapy for nasopharyngeal carcinoma
Authors
KeywordsInterruption
Nasopharyngeal carcinoma
Overall treatment time
Timing of interruption
Issue Date1997
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 1997, v. 39 n. 3, p. 703-710 How to Cite?
AbstractPurpose: The effect of interruptions and prolonged overall treatment time in radiotherapy for nasopharyngeal carcinoma and the significance of timing of interruption was investigated. Methods and Materials: Treatment records of 229 patients treated with continuous course (CC) and 567 patients treated with split course (SC) radiotherapy for nonmetastatic NPC were reviewed. Overall treatment time without inclusion of time for boost was calculated. Treatment that extended 1 week beyond scheduled time was considered prolonged. Outcome in patients who completed treatment 'per schedule' were compared with those who had 'prolonged' treatment. Because of known patient selection bias between CC and SC, patients on the two schedules were analyzed separately. Multivariate analysis was performed for patients on SC. Total number of days of interruption, age, sex, T and N stage, and the use of boost were tested for the whole SC group. Analysis on the effect of timing of interruption was performed in a subgroup of 223 patients on SC who had a single unplanned interruption. Timing of interruption, either before or after the fourth week for the unplanned interruption, was tested in addition to the other variables in multivariate analysis for this subgroup of SC. Results: Twenty-seven (11.8%) patients on CC and 96 (16.9%) patients on SC had prolonged treatment. Patients on SC who had prolonged treatment had significantly poorer loco-regional control rate and disease free survival when compared with those who completed radiotherapy per schedule (p = 0.0063 and 0.001, respectively, with adjustment for stage). For CC, the effect of prolonged treatment on outcome was not significant. The small number of events for patients on CC probably account for the insignificant finding. The number of days of interruption was confirmed as prognostic factor, independent of T and N stages, for loco-regional control and disease-free survival in multivariate analysis for SC. The hazard rate for loco-regional failure increased by 3.3% for each day of interruption. The timing of interruption, at the beginning or towards end of treatment, did not significantly alter outcome. Conclusion: Interruptions and prolonged treatment adversely affect outcome in radiotherapy for NPC and the effect of repopulation was confirmed. Every effort should be made to keep treatment on schedule and interruptions for whatever reasons should be minimized.
Persistent Identifierhttp://hdl.handle.net/10722/150731
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKwong, DLWen_US
dc.contributor.authorSham, JSTen_US
dc.contributor.authorChua, DTTen_US
dc.contributor.authorChoy, DTKen_US
dc.contributor.authorAu, GKHen_US
dc.contributor.authorWu, PMen_US
dc.date.accessioned2012-06-26T06:09:21Z-
dc.date.available2012-06-26T06:09:21Z-
dc.date.issued1997en_US
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 1997, v. 39 n. 3, p. 703-710en_US
dc.identifier.issn0360-3016en_US
dc.identifier.urihttp://hdl.handle.net/10722/150731-
dc.description.abstractPurpose: The effect of interruptions and prolonged overall treatment time in radiotherapy for nasopharyngeal carcinoma and the significance of timing of interruption was investigated. Methods and Materials: Treatment records of 229 patients treated with continuous course (CC) and 567 patients treated with split course (SC) radiotherapy for nonmetastatic NPC were reviewed. Overall treatment time without inclusion of time for boost was calculated. Treatment that extended 1 week beyond scheduled time was considered prolonged. Outcome in patients who completed treatment 'per schedule' were compared with those who had 'prolonged' treatment. Because of known patient selection bias between CC and SC, patients on the two schedules were analyzed separately. Multivariate analysis was performed for patients on SC. Total number of days of interruption, age, sex, T and N stage, and the use of boost were tested for the whole SC group. Analysis on the effect of timing of interruption was performed in a subgroup of 223 patients on SC who had a single unplanned interruption. Timing of interruption, either before or after the fourth week for the unplanned interruption, was tested in addition to the other variables in multivariate analysis for this subgroup of SC. Results: Twenty-seven (11.8%) patients on CC and 96 (16.9%) patients on SC had prolonged treatment. Patients on SC who had prolonged treatment had significantly poorer loco-regional control rate and disease free survival when compared with those who completed radiotherapy per schedule (p = 0.0063 and 0.001, respectively, with adjustment for stage). For CC, the effect of prolonged treatment on outcome was not significant. The small number of events for patients on CC probably account for the insignificant finding. The number of days of interruption was confirmed as prognostic factor, independent of T and N stages, for loco-regional control and disease-free survival in multivariate analysis for SC. The hazard rate for loco-regional failure increased by 3.3% for each day of interruption. The timing of interruption, at the beginning or towards end of treatment, did not significantly alter outcome. Conclusion: Interruptions and prolonged treatment adversely affect outcome in radiotherapy for NPC and the effect of repopulation was confirmed. Every effort should be made to keep treatment on schedule and interruptions for whatever reasons should be minimized.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_US
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_US
dc.rightsInternational Journal of Radiation: Oncology - Biology - Physics. Copyright © Elsevier Inc.-
dc.subjectInterruption-
dc.subjectNasopharyngeal carcinoma-
dc.subjectOverall treatment time-
dc.subjectTiming of interruption-
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAnalysis Of Varianceen_US
dc.subject.meshCarcinoma - Pathology - Radiotherapy - Secondaryen_US
dc.subject.meshDose Fractionationen_US
dc.subject.meshEquipment Failureen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNasopharyngeal Neoplasms - Pathology - Radiotherapyen_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshPatient Complianceen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTreatment Failureen_US
dc.titleThe effect of interruptions and prolonged treatment time in radiotherapy for nasopharyngeal carcinomaen_US
dc.typeArticleen_US
dc.identifier.emailKwong, DLW:dlwkwong@hku.hken_US
dc.identifier.emailChua, DTT:dttchua@hkucc.hku.hken_US
dc.identifier.authorityKwong, DLW=rp00414en_US
dc.identifier.authorityChua, DTT=rp00415en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0360-3016(97)00339-8en_US
dc.identifier.pmid9336153-
dc.identifier.scopuseid_2-s2.0-0030929185en_US
dc.identifier.hkuros34744-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030929185&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume39en_US
dc.identifier.issue3en_US
dc.identifier.spage703en_US
dc.identifier.epage710en_US
dc.identifier.isiWOS:A1997YA91700026-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridKwong, DLW=15744231600en_US
dc.identifier.scopusauthoridSham, JST=7101655565en_US
dc.identifier.scopusauthoridChua, DTT=7006773480en_US
dc.identifier.scopusauthoridChoy, DTK=7102939127en_US
dc.identifier.scopusauthoridAu, GKH=7003748615en_US
dc.identifier.scopusauthoridWu, PM=8663653900en_US

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