Conclusions
ONCOLOGY, SECONDARY
In this secondary analysis of 3 NRG Oncology randomized clinical trials, prolonged RT duration was associated with inferior outcomes. Female patients and those with other race and ethnicity were more likely to have prolonged RT duration and experience RT interruptions. Radiotherapy interruptions should be minimized to optimize outcomes. As a practical recommendation, for a patient starting a course of 28 fractions of RT on a Monday, the goal should be to complete the treatment course by Friday of the sixth week (ie, <40 days). Treatment interruptions should be minimized by using aggressive supportive care and interventions to reduce patient nonadherence. If interruptions occur, incorporating weekend and/or twice-daily treatments, if appropriate, could be considered to keep the treatment duration less than 40 days. Findings from the present study suggest that investigating further reduction in RT duration (<5 weeks) might be warranted, such as through use of moderate hypofractionation RT regimens.