The CHART regimen and morbidity.

In 1984, when the CHART regime was devised, it was predicted that acute reactions in skin and mucosae would be more severe but that there would be a considerable reduction of late effects in normal tissues. The findings from the pilot study conducted from 1985 to 1990 and from the randomized trials, which entered cases from 1990 to 1995, are reviewed. With CHART, it was found that acute mucosal reactions were more severe but tolerable and recoverable. Unexpectedly, acute skin reactions were reduced rather than increased. Late reactions in the central nervous system have led to a dose restriction of 40 Gy. Effects in other normal tissues were significantly reduced but the sparing effect was less than that predicted. This can perhaps be explained by a half-time of repair of sublethal injury in human tissues in excess of 4 h.