Basic Clinical Radiobiology 2017

Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. M. Morris et al, NEJM, 340:1137-1143, 1999.

RT RT+Chemo (n=193) (n=195)

5y overall survival

58% 35% 33%

73 (p=0.004) 19% (p<0.001) 14% (p<0.001)

LR recurrence Distant relapse

RT: 45 Gy + brachytherapy (total dose ≥ 85 Gy) Chemo: cddp (75mg/m 2 , d1), 5Fu (1g/m 2 /d, d1-4), x3

ESTRO 2017

Combined chemo- and radiotherapy treatment

• Spatial co-operation (e.g. breast carcinoma) • Independent cell kill (e.g. Hodgkin lymphoma) • Interaction (e.g. H&N, cervix, NSCLC) • “diluted” toxicity (e.g. Hodgkin lymphoma)

ESTRO 2017