To assess skin dose and incidence of skin reactions in early breast cancer patients treated via Intrabeam™ intraoperative radiation therapy (IORT) device.

In total, 250 breast cancer patients treated with a single fraction of 20 Gy using 50 kV photon were recruited. The applicator to skin distance (ASD) was measured before the initiation of the radiation and the skin dose in each patient was accordingly calculated based on the treatment planning system (TPS).

The average skin doses calculated were equal to 7·91, 5·83, 3·96 and 2·14 Gy for 6–10, 10–15, 15–20 and 20–30 mm ASD values, respectively. It is noticeable that the skin doses could be lower than the TPS measurements up to 45%, mostly due to lack of backscatter radiation in breast tissue compared with the full scatter condition in the Zeiss water phantom. Finally, only three patients showed low-grade skin reactions 1 week after IORT. A review of the related literature also revealed the incidence of lower skin complications among patients treated via Intrabeam™ compared with MammoSite™ machine.

The Intrabeam™ TPS did not seem to be very reliable for accurate skin dosimetry. However, breast cancer treatment using Intrabeam™ could result in fewer incidences of skin reactions than MammoSite™ machine.

To compare the dosimetric outcomes of linear accelerator-based stereotactic radiotherapy (SRT) techniques—static conformal field (SCF), static conformal arc (SCA) and dynamic conformal arc (DCA), for treating pituitary adenoma and craniopharyngioma.

Computer image sets of 20 patients with pituitary adenoma or craniopharyngioma and treated with post-operative SRT were selected for this study. For each dataset, three SRT plans, with SCF, SCA and DCA techniques were generated using Brain LAB, iPlan RT V.4.5.3, TPS software. The conformity index (CI), homogeneity index (HI), quality of coverage of the target, dose–volume histograms for the target and organs at risk (OARs) and the time taken to deliver treatment was compared across three sets of plan.

There were 12 patients with pituitary adenoma and eight with craniopharyngioma. The CI and HI were comparable across three techniques. The quality of coverage was superior in DCA technique. OARs were better spared in SCF and DCA techniques. Time taken to deliver treatment was least in SCF technique.

The linac-based SRT techniques SCF, SCA and DCA are efficient in delivering highly conformal and homogenous dose to the target in pituitary adenoma and craniopharyngioma. Among these three techniques, SCF and DCA had acceptable quality of coverage. The dose received by OARs was least in the SCF technique.

The aim of this study is to review the results of applying a hypofractionated radiotherapy schedule for locally advanced inoperable lung cancer in patients who have received chemotherapy. Lung cancer and especially non-small-cell lung cancer is prone to accelerated repopulation and shorter treatment schedules in the form of accelerated radiotherapy have been shown to improve treatment outcome.

In total, 29 patients with inoperable lung cancer (stage II, IIIa,b, IV) were treated with accelerated hypofractionated 3D conformal radiotherapy. All patients received a dose of 55 Gy in 20 fractions (daily dose of 2·75 Gy). The median age was 65·5 years, 87% of patients had stage III–IV disease, 93% of patients received sequential chemotherapy with their radiotherapy. Median follow-up of patients was 36 months.

The median overall survival from time of diagnosis was 16·5 months and the 1 year overall survival was 31%. Complications were present in 44·8% of the patients and the most common complication (20·7%) was pneumonitis alone. The complication rate was not significantly different according to histological type, stage, type of chemotherapy, presence of recurrence or death.

Although our study limitation is the small number of patients, these data suggest that the efficacy of this hypofractionated schedule could be considered as alternative option to the conventional regimen of 66 Gy given in 33 fractions.

To investigate discrepancies in dose calculation algorithms used for lung stereotactic body radiotherapy (SBRT) plans.

In total, 30 patients lung SBRT treatment plans, initially generated using BrainLab Pencil Beam (BL_PB) algorithm for 10 Gy×5 Fractions to the planning target volume (PTV) were included in the study. These plans were recalculated using BrainLab Monte Carlo (BL_MC), Eclipse AAA (EC_AAA), Eclipse Acuros XB (EC_AXB) and ADAC Pinnacle CCC (AP_CCC) algorithms. Dose volume histograms of PTV were used to calculate dosimetric and radiobiological quality indices, and equivalent dose to 2 Gy per fraction using linear-quadratic-linear model. The BL_MC algorithm is considered gold standard tool to compare PTV parameters and quality indices to investigate dose calculation discrepancies of abovementioned plans.

BL_PB overestimates doses that may be due to inability of the algorithm to properly account for electron scattering and transport in inhomogeneous medium. Compared with BL_MCNO plans, the EC_AAA and EC_AXB yield lower homogeneity indices and overestimate the dose in the penumbra region, whereas AP_CCC plans were comparable for small PTV (≈8 cc) and had significant difference for large PTV.

BL_PB algorithm overestimates PTV doses than BL_MC calculated doses. The EC_AAA, EC_AXB and AP_CCC algorithms calculate doses within acceptable limits of radiotherapy dose delivery recommendations.

This study deals with the characteristics of simultaneous photon and electron beams in homogenous and inhomogeneous phantoms by experimental and Monte Carlo dosimetry, for therapeutic purposes. Materials and methods: Both 16 and 20 MeV high-energy electron beams were used as the original beam to strike perforated lead sheets to produce the mixed beam. The dosimetry results were achieved by measurement in an ion chamber in a water phantom and film dosimetry in a Perspex nasal phantom, and then compared with those calculated through a simulation approach. To evaluate two-dimensional dose distribution in the inhomogeneous medium, the dose–area histogram was obtained.

The highest percentage of photon contribution in mixed beam was found to be 36% for 2-mm thickness of lead layer with holes diameter of 0·2 cm for a 20 MeV primary electron energy. For small fields, the percentage depth dose parameters variations were found to be similar to pure electron beam within ±2%. The most feasible flatness in beam profile was 11% for pure electron and 7% for the mixed beam. Penumbra changes as function of depth was about ten times better than in pure electron field.

The results present some dosimetric advantages that can make this study a platform for the production of simultaneous mixed beams in future linear accelerators (LINACs), which through redesign of the LINAC head, which could lead to setup error reduction and a decrease of intra-fractional tumour cells repair.

To evaluate the impact of couch translational shifts on dose–volume histogram (DVH) and radiobiological parameters [tumour control probability (TCP), equivalent uniform dose (EUD) and normal tissue complication probability (NTCP)] of volumetric modulated arc therapy (VMAT) plans and to develop a simple and swift method to predict the same online, on a daily basis.

In total, ten prostate patients treated with VMAT technology were selected for this study. The plans were generated using Eclipse TPS and delivered using Clinac ix LINAC equipped with a Millennium 120 multileaf collimator. In order to find the effect of systematic translational couch shifts on the DVH and radiobiological parameters, errors were introduced in the clinically accepted base plan with an increment of 1 mm and up to 5 mm from the iso-centre in both positive and negative directions of each of the three axis, x [right–left (R-L)], y [superior–inferior (S-I)] and z [anterior–posterior (A-P)]. The percentages of difference in these parameters (∆D, ∆TCP, ∆EUD and ∆NTCP) were analyzed between the base plan and the error introduced plans. DVHs of the base plan and the error plans were imported into the MATLAB software (R2013a) and an in-house MATLAB code was generated to find the best curve fitted polynomial functions for each point on the DVH, there by generating predicted DVH for planning target volume (PTV), clinical target volume (CTV) and organs at risks (OARs). Functions f(x, vj), f(y, vj) and f(z, vj) were found to represent the variation in the dose when there are couch translation shifts in R-L, S-I and A-P directions, respectively. The validation of this method was done by introducing daily couch shifts and comparing the treatment planning system (TPS) generated DVHs and radiobiological parameters with MATLAB code predicted parameters.

It was noted that the variations in the dose to the CTV, due to both systematic and random shifts, were very small. For CTV and PTV, the maximum variations in both DVH and radiobiological parameters were observed in the S-I direction than in the A-P or R-L directions. ∆V70 Gy and ∆V60 Gy of the bladder varied more due to S-I shift whereas, ∆V40 Gy, ∆EUD and ∆NTCP varied due to A-P shifts. All the parameters in rectum were most affected by the A-P shifts than the shifts in other two directions. The maximum percentage of deviation between the TPS calculated and MATLAB predicted DVHs of plans were calculated for targets and OARs and were found to be less than 0·5%.

The variations in the parameters depend upon the direction and magnitude of the shift. The DVH curves generated by the TPS and predicted by the MATLAB showed good correlation.

This study aimed to examine the dosimetric properties of Gafchromic® EBT3 film and intensity-modulated radiation therapy quality assurance (IMRT QA).

Beams characteristics dosimetric properties and 20 IMRT plans were created and irradiated on Varian dual-energy DHX-S Linac for 6 and 15 MV energies. EBT3 films were analysed using ‘film Pro QA 2014’ software.

The dosimetric comparison of EBT3 film (for red channel dosimetry) and ionisation ion chamber measurement showed that average deviations of symmetry, flatness, central axis, penumbra (left) and penumbra (right) of dose profile were 0·18, 1·34, 0·49%, 3·68 and 3·61 mm for 6 MV and 0·10, 1·3, 0·45, 2·65 and 2·71 mm for 15 MV, respectively. The blue and green channels dosimetry showed greater dose deviation as compared with red channel. IMRT QA verification plan complied about 95% at all different criteria. Reproducibility, stability and face orientation of film were within 1·4% for red channel.

The results advocate that the film can be used not only for dosimetric assessment but also as a reliable IMRT QA tool.

To investigate the necessity of rotational shifts by considering dosimetric impact of rotational errors on stereotactic body radiation therapy (SBRT).

20 lung patients with the lesion size <5 cm treated with SBRT have been selected for dosimetric analysis. Three-dimensional dose has been rotationally shifted (±1°, ±3°, ±5° for pitch, roll and yaw) and overlaid to the original computed tomography images. The dose–volume histograms of 18-rotational plans of each patient were compared to those of the original plan.

No significant dosimetric differences were observed in target coverage. For all of the cases up to 5° in any couch angle dose differences of D99 and D95 were <3%. Variations of conformity index were observed to be less than 0·05. None of the organ at risk doses exceeded the dose limit. The V20 differences of the ipsilateral and the total lungs were less than 0·4%.

It has been found to be unnecessary to perform rotational shifts up to 5° for lung SBRT treatments; the translational shift is sufficient for the cases used in this study. This method may be applied and tested after planning and before treatment initiation to rule out exceptionally extreme cases.

The purpose of this study was to investigate whether significant difference exists on radiation dose delivered to organs at risks in megavoltage computed tomography (MVCT) verification using three predefined scanning modes, namely fine (2 mm), normal (4 mm) and coarse (6 mm). This will provide information for the imaging protocol of tomotherapy for the left breast.

Organ doses were measured using thermoluminescent dosimeters (TLD-100) placed within a female Rando phantom for MVCT imaging. Kruskal–Wallis test was conducted with p<0·05 to evaluate the significant difference between the three MVCT scanning modes.

Statistically significant difference existed in organ absorbed dose between different scan mode selections (p<0·001). Relative to the normal scan selection (4 mm), the absorbed dose to the organs of interests can be scaled down by 0·7 and scaled up by 2·1 for coarse (6 mm) and fine scans (2 mm) respectively.

Optimisation of imaging protocols is of paramount importance to keep the radiation exposure ‘as low as reasonably achievable’. The recommendation of undergoing daily coarse mode for MVCT verification in breast tomotherapy not only mitigates the radiation exposure to normal tissues, but also trims the scan-acquisition time.

The aim of this study was to understand how the regulatory requirements for functioning radiotherapy practices in India to control risk were conceptualised, perceived and applied accordingly in the radiotherapy facilities. It further examined how the social factors influenced the decision-making process for implementing regulatory requirements in the radiotherapy facilities.

This study was carried out in nine radiotherapy facilities located in the northeastern Indian states of Manipur, Assam, Meghalaya, Tripura and Mizoram. The study adopted both the semi-structured and in-depth questionnaire, developed on the basis of multidisciplinary fields.

The study found that the facilities in the northeastern regions were commissioned in line with the regulatory requirements. The facilities had adequate structural shielding rooms to protect workers, patients and the public from the risk of ionising radiation. However, in the operational phase of the facilities, majority of the facilities had the improper management of existing resources and non-implementation of regulatory requirements on time. It was observed that workers in some facilities continued the practice, despite the failure of specific safety functions, or not meeting regulatory requirements. Such practices led to the suspension of patient treatment in three of the facilities by the regulator. The existence of a varying nature of risk perceptions among oncologists, medical physicists, radiological safety officers, radiotherapy technologists in the facilities were observed and these influenced the decision-making process of the facilities on the implementation of regulatory requirements.

The study found that the facilities needed to explore various means, including to narrow the gap that existed in respects of perceived risk (within the facilities), communication to enhance work coordination and mutual trust among workers. The adoption of the institutional policy for conducting an internal audit of working practices, encouragement of workers to participate in continuing education programs would enhance effective utilisation of already existing infrastructure/equipment and work procedures including quality assurance programs.

Cervical cancer is considered to be the fourth most frequent cancer among women. Postoperative treatment is indicated depending up on surgical findings and disease stage.

The objective of this study was to assess the long-term postoperative outcomes of cervical cancer patients with intermediate risk factors who have received pelvic external beam radiotherapy with or without vaginal brachytherapy, and treatment-related toxicities.

In this retrospective study, the records were collected for all patients with cervical cancer who received postoperative radiotherapy at the National Cancer Institute between the years 2008 and 2013. The end points of the study were local control, progression-free survival, overall survival (OS) and delayed complications.

Out of 248 patients, the median age of patients who did not receive brachytherapy was 53 years and the median age of patients who received brachytherapy was 52 years. A statistically significant difference was found in OS, progression-free survival and recurrence-free survival for those who received brachytherapy, with a p value<0·001, 0·01 and 0·004, respectively.

The addition of brachytherapy to postoperative external beam radiotherapy improves OS, progression-free survival and local control for patients with intermediate-risk cervical cancer.

Whole-breast external beam radiotherapy results in significant reduction in the risk for breast cancer-related death, but this may be offset by an increase in deaths from other causes and toxicity to surrounding organs. Partial breast irradiation techniques are approaches that treat only the lumpectomy area rather than the whole breast. Quality assurance in the radiation therapy treatment planning process is essential to ensure accurate dose delivery to the patient. For this purpose, this article compares the results from an anthropomorphic PRESAGE® dosimeter, radiation treatment planning system and from the GAFCHROMIC® EBT2 film.

A breast dosimeter was created and a three-field partial plan was generated in the Pinnacle3 treatment planning system. Dose distribution comparisons were made between Pinnacle3 treatment planning system, GAFCHROMIC® EBT2 film and PRESAGE® dosimeter. Dose–volume histograms (DVHs), gamma maps and line profiles were used to evaluate the comparison.

DVHs of gross tumour volume, clinical tumour volume and planning tumour volume for the PRESAGE® dosimeter and Pinnacle3 treatment planning system shows that both measured and calculated statistics were in agreement, with a value of 97.8% of the prescribed dose. Gamma map comparisons showed that all three distributions passed 95% at the ±3%/±3 mm criteria. Comparisons of isodose line distribution between the PRESAGE® dosimeter, EBT2 film and planning system demonstrated agreement, with an average difference of 1.5%.

This work demonstrated the feasibility of PRESAGE® to function as an anthropomorphic phantom and laid the foundation for research studies in PRESAGE®/optical-computed tomography three-dimensional dosimetry with the most complex anthropomorphic phantoms.

To examine and quantify set-up errors in patient positioning in head-and-neck radiotherapy and to investigate the impact of the choice of reference isocentre—on the patient neck or patient skull—on the magnitude of set-up errors.

Set-up position corrections obtained using online kV 2D/2D matching were recorded automatically for every treatment fraction. 3,413 treatment records for 117 patients treated with volumetric modulated arc therapy during 2013 and 2014 on a single treatment machine in our clinic were analysed. In 79 treatment plans the reference isocentre was set to the patient skull, and in 47 to the neck.

Standard deviation of group systematic error in the vertical, longitudinal and lateral direction and the couch rotation were found to be 2·5 mm, 2·1 mm, 1·9 mm and 0·43° (skull) and 2·5 mm, 1·8 mm, 1·7 mm and 0·49° (neck), respectively. Random error of the vertical, longitudinal, lateral and rotational position correction was 1·8 mm, 1·5 mm, 1·6 mm and 0·62° (skull) and 1·9 mm, 1·6 mm, 1·5 mm and 0·60° (neck), respectively. Positional shifts in different directions were found to be uncorrelated.

Neither reference isocentre set-up shows a clear advantage over the other in terms of interfraction set-up error.

The aim of this study is to establish clinical evidence regarding the use of magnetic resonance imaging (MRI) in target volume definition for radiotherapy treatment planning of brain tumours.

Primary studies were systematically retrieved from six electronic databases and other sources. Studies included were only those that quantitatively compared computed tomography (CT) and MRI in target volume definition for radiotherapy of brain tumours. Study characteristics and quality were assessed and the data were extracted from eligible studies. Effect estimates for each study was computed as mean percentage difference based on individual patient data where available. The included studies were then combined in meta-analysis using Review Manager (RevMan) software version 5.0.

Five studies with a total number of 72 patients were included in this review. The quality of the studies was rated strong. The percentages mean differences of the studies were 7·47, 11·36, 30·70, 41·69 and −24·6% using CT as the baseline. The result of statistical analysis showed small-to-moderate heterogeneity; τ2=36·8; χ2=6·23; df=4 (p=0·18); I2=36%. The overall effect estimate was −1·85 [95% confidence interval (CI); −7·24, 10·94], Z=0·40 (p=0·069>0·5).

Brain tumour volumes measured using MRI-based method for radiotherapy treatment planning were larger compared with CT defined volumes but the difference lacks statistical significance.

Imaging protocols are implemented to identify and minimise set-up errors. A crucial component to the success of these protocols is staff compliance.

This is case report describing a retrospective review of radiation therapists’ compliance to a palliative imaging protocol in a single large institution in one calendar year.

The review showed a non-compliance to protocol for 8% of treatments. The most frequent protocol deviation was a failure to calculate the mean set-up displacement after 2/3 days of consecutive imaging.

Despite the presence of institutional evidence-based palliative imaging protocol unwanted deviations in practice can occur.

In the United Kingdom, 7·1% of people aged over 65 live with dementia. The National Dementia Strategy emphasises the need for a skilled workforce competent in dementia care. In all, 50% of cancer patients are in the 70 plus age group, suggesting that education of therapeutic radiographers in the care of the patient with dementia is key. The aim of the study was to review the literature regarding training of therapeutic radiographers on dementia and use the findings to make recommendations for training in the future in order to provide the best care.

A literature search of electronic databases holding peer-reviewed journals was conducted. Search terms were generated using the Population Intervention Comparison Outcome (PICO) method and retrieved articles were evaluated using the Critical Appraisal Skills Programme (CASP) tool. Additional evidence was accessed through snowballing and from grey literature.

The search failed to find any studies on dementia care education within a radiotherapy setting and only a limited number were found in the acute care setting. There appeared to be a large variation in the education provision for healthcare professionals on the subject of dementia care, both at the pre-registration and post-registration stages.

There is no evidence of a standardised education programme for healthcare professionals in dementia care. In the future, therapeutic radiographers are likely to see more patients with dementia but currently some may not have had the education and training to provide effective holistic care.

To characterise small photon beams using the Monte Carlo dose calculation algorithm for small field ranges in a heterogeneous medium.

An in-house phantom constructed with three different mediums, foam, polymethyl methacrylate and delrin resembling the densities of lung, soft tissue and bone respectively, was used in this study. Photon beam energies of 6 and 15 MV and field sizes of 8×8, 16×16, 24×24, 32×32 and 40×40 mm using X-ray voxel Monte Carlo (XVMC) algorithm using different detectors were validated. The relative output factor was measured in three different mediums having six different tissue interfaces; at the depth of 0, 1, 2 and 3 cm. The planar dose verification was undertaken using gafchromic films and considered dose at the lung and bone medium interfaces. For all the measurements, 104×104 mm was taken as the reference field size. The relative output factor for all other field sizes was taken and compared with planning system calculated values.

From field size 16×16 mm and above, the relative output factors were analysed in bone and soft tissue medium having lung as first medium. The maximum deviations were observed as 1·8 and 1·3% for 6 MV and 2·5 and 1·1% for 15 MV photon beams for bone and soft tissue, respectively. For lung as measurement medium, the maximum deviation of 14·8 and 19·2% were observed and having bone as first medium with 8×8 mm for 6 and 15 MV photon beams, respectively. The fluence verification of dose spectrum for the lung–bone interface scenarios with smaller field sizes were found within 2% of deviation with treatment planning system (TPS).

The accuracy of dose calculations for small field sizes in XVMC-based treatment planning algorithm was studied in different inhomogeneous mediums. It was found that the results correlated with measurement data for field size 16×16 mm and above. Noticeable deviation was observed for the smallest field size of 8×8 mm with interfaces of significant change in density. The observed results demands further analysis of work with smaller field sizes.

In radiotherapy, electron beam irradiation is an effective modality for superficial tumours. Electron beams have good coverage of tumours which involve the skin, however there is an issue about electron scattering and tissue heterogeneity. This subsequently demands dosimetric analysis of electron beam behaviour, particularly in the treatment of lesions on the scalp requiring the application of treatment to scalp curvatures. There are various methods which are used to treat scalp malignancies including photons and electrons, but, the later needs precise dosimetry before each session of treatment. The purpose of the study was to undertake a detailed analysis of the dosimetry of electron beams when applied to the curved surface of the scalp using Gafchromic® EBT2 films.

A rando phantom and Gafchromic® EBT2 films were used for dosimetric analysis. A gafchromic calibration curve was plotted and an in-treatment beam dosimetric analysis was carried out using dosimetry films placed on the scalp. Electron behaviour was assessed by introducing five electron fields in particular curvature regions of scalp.

There was an acceptable dose range through all five fields and hotspots occurred in the curved borders. In our study, skin doses and doses at the field junctions, with no gaps, were between 78–97% and 80–97%, respectively.

Electron beams are a good modality for treating one flat field, but in the special topography of the scalp, whole scalp treatment requires precise field matching and dosimetry. In undertaking this detailed dosimetric analysis using a rando phantom and Gafchromic® EBT2 films, it is concluded that this method requires further detailed analysis before using in clinics.

Accurate three-dimensional dosimetry is essential in modern radiotherapy techniques such as volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). In this research work, the PRESAGE® dosimeter was used as quality assurance (QA) tool for VMAT planning for head and neck (H&N) cancer.

Computer tomography (CT) scans of an Image Radiation Oncology Core (IROC) H&N anthropomorphic phantom with both IROC standard insert and PRESAGE® insert were acquired separately. Both CT scans were imported into the Pinnacle (9.4 version) TPS for treatment planning, where the structures [planning target volume (PTV), organs at risk) and thermoluminescent detectors (TLDs) were manually contoured and used to optimise a VMAT plan. Treatment planning was done using VMAT (dual arc: 182°–178°, 178°–182°). Beam profile comparisons and gamma analysis were used to quantify agreement with film, PRESAGE® measurement and treatment planning system (TPS) calculated dose distribution.

The average ratio of TLD measured to calculated doses at the four PTV locations in the H&N phantom were between 0·95 to 0·99 for all three VMAT deliveries. Dose profiles were taken along the left–right, the anterior–posterior and superior–inferior axes, and good agreement was found between the PRESAGE® and Pinnacle profile. The mean value of gamma results for three VMAT deliveries in axial and sagittal planes were found to be 94·24 and 93·16% when compared with film and Pinnacle, respectively. The average values comparing the PRESAGE® results and dose values calculated on Pinnacle were observed to be 95·29 and 94·38% in the said planes, respectively, using a 5%/3 mm gamma criteria.

The PRESAGE® dose measurements and calculated dose of pinnacle show reasonable agreement in both axial and sagittal planes for complex dual arc VMAT treatment plans. In general, the PRESAGE® dosimeter is found to be a feasible QA tool of VMAT plan for H&N cancer treatment.

This study aims to clarify the influence of overall treatment time (OTT) on the efficiency of combined chemo-radiotherapy in cervical cancer.

This retrospective study enrolled 122 cervical cancer patients who had squamous cell carcinoma and had undergone definitive chemo-radiotherapy from 2009 to 2013. All patients received whole pelvic radiotherapy (WPRT) with the dose of 50 Gy in 25 fractions (with central shielding after 44 Gy) plus intracavitary brachytherapy with the dose of 28 Gy in four fractions. During WPRT, all patients received concurrent chemotherapy with weekly platinum-based regimen. The data of patient characteristics, OTT, treatment results and toxicities were collected and evaluated.

The mean follow-up time was 36 months. The mean age of patients was 52 years old; 68% of patients were stage IIB related to International Federation of Gynaecology and Obstetrics staging. Pelvic control (PC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates did not differ significantly in the data-derived cut points of 55·8 and 53 days. No statistically significant difference in treatment results between the two groups of OTT<49 and OTT≥62 days was observed.

In our data-derived cut point, OTT did not influence to PC, DMFS, DFS and OS. The influence of OTT on treatment results may be found in longer periods.