To the Editor.—The recent article by Pearlman et al,1 was based on reports of 22 patients who had previously received radiation treatment, yet no radiation oncologist was listed as an author. The statement that previous radiotherapy "ranged from 3000 to 12 000 rad (30 to 120 Gy), with all but one patient having received at least 4000 rad (40 Gy)" is unacceptable without further explanation. Radiation doses cannot be specified as a simple range, as though they are comparable to blood loss volumes.
Most importantly, with any fractionation, 120 Gy (12 000 rad) is above the radiotolerance of pelvic structures unless radioactive implants were performed, with doses specified at or close to the surface of the sources.
Also, complication rates as well as control rates, either after radiotherapy alone or after surgery, are dependent on the total dose, fractionation, and field size. It would have been very helpful