Treatment Interruptions or Delays with Radiation

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July 28, 2008 - 4:01 pm email to a friend printer friendly view / write comments

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Dr. Mehta

   Despite the acute side effects, it is important to try and deliver the radiation treatment without any interruptions or delays in treatment.  Experiments in the laboratory with cancer cell lines demonstrate quite convincingly that interrupting the radiation treatment even for a few days allows the cancer cells to grow back.  A large retrospective study has demonstrated that the survival is significantly worse if patients had an interruption in their treatment of longer than 5 days.  These results have also demonstrated that patients that go through the treatment without an interruption have a statistically higher chance of beating the disease than patients that experience an interruption in their treatment.  Sometimes the interruption in treatment is simply unavoidable (i.e., because a patient is simply too sick), but treatment interruptions scheduled out of convenience should be avoided if at all possible.

   Here are some startling numbers.  In one study, an interruption in radiation of one week (meaning that the patient was given 5 days off during a 5-7 week course of radiation), resulted in 9% decrease in the overall survival at 3 years.  In another study, the analysis indicated that for each day missed (and the overall treatment time was prolonged) there was a 2% decrease in survival.  Of course, not all studies have confirmed these observations but many have.  These types of clinical data have also been observed when radiation is used to treat cervical cancer, head and neck cancer and other malignancies.  Because the clinical data across tumor types matches very well with what has been observed in the laboratory, I think that treatment interruptions should be avoided if at all possible. 

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