title: Local control rate of split-course irradiation combined with chemotherapy for head and neck cancer.
abstract: Between 1976 and 1984, 99 patients were treated with radical external irradiation (RT) for squamous cell carcinoma of the head and neck excluding the glottis and paranasal cavity. Twenty-six out of 55 patients (47%) on chemotherapy (CT) were treated by split-course (split) RT, mainly because of acute mucositis. Only 8 out of 44 patients (18%) not on CT were treated by split RT. Although the group given split RT alone rested for 14 days and received 35 Gy, the split RT + CT group rested for 16 days and received a lower dose (30.5 Gy). The mean total doses for each treatment modality were 64 Gy in the continuous course (contin.) of RT alone, 63 Gy in contin. RT + CT, 67 Gy in split RT, and 62 Gy in split RT + CT. The observed/predicted (by a Radiation Therapy Oncology Group) control ratios of primary lesions at 2 yrs were 61/80 (0.76), 72/83 (0.87), 75/73 (1.03), and 69/71 (0.97), respectively. Among patients with a predicted rate of over 80%, the observed rates were almost identical (72%, 74%, 4/4, and 75%, respectively). However, for patients with predicted rates of 50-80%, the observed rate was 71% (12/17) in the group given combined therapy against 50% (5/10) in RT alone group. Among patients with predicted rates under 50%, the observed rate was 57% (4/7) in split RT + CR and only 25% (1/4) in contin. RT; there were no cases in contin. RT + CT. Split RT + CT is considered to be favorable for patients with poor prognostic factors.
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011379:Prognosis