A hypofractionated radiotherapy regimen (0-7-21) for advanced gynaecological cancer patients

To evaluate the efficacy of a palliative three fraction radiation regimen delivered on days 0, 7 and 21 (0-7-21 regimen) for advanced stage gynaecological cancer patients.

Fifty-one patients with advanced gynaecological cancer who were treated with the 0-7-21 regimen between 1998 and 2008 were identified. The median follow-up period was 1.4 months (range 0.2-33.4). Treatment completion data, symptomatic response, toxicity and survival were retrospectively analysed.

Forty-eight patients received at least two of the three planned fractions. Complete and partial responses of vaginal bleeding were seen in 92% of 26 evaluable patients. Complete and partial responses of pain were seen in 76% of 25 evaluable patients. Eighteen of the 33 evaluable patients experienced grade 1/2 acute toxicity. No patients experienced grade 3/4 toxicity. Grade 1/2 and grade 3 late toxicity occurred in four and one of 12 evaluable patients, respectively. Grade 5 toxicity was assigned in two patients. It was uncertain whether these deaths were radiation related or due to tumour progression. Eleven patients survived longer than 12 months.

The 0-7-21 regimen provided effective and rapid symptomatic relief with acceptable toxicity, and offered the advantage of convenience for most patients. It offers an alternate treatment option for carefully selected patients with incurable gynaecological malignancies.