Advanced carcinomas of the oropharynx treated with radiotherapy--a comparison of three different fractionation schemes.
BACKGROUND
This report reflects a retrospective comparison among historical series of patients with similar site and stage of disease treated by three fractionation schemes.


METHODS
A hyperfractionation (HF) scheme delivered 1 Gy three times a day, 5 days a week, to a total dose of 60 to 63 Gy over 26 to 29 days. A group of 48 patients received HF. Accelerated fractionation (AF) consists of 2 Gy three times a day, 5 days a week, to a total of 48 to 52 Gy delivered over 11 to 12 days. A group of 46 patients underwent this therapy. A third group of 48 patients were treated with conventional fractionation (CF). These patients received 2 Gy each day, 5 days a week, to a total dose of 60 to 66 Gy.


RESULTS
Ned survival at 5 years was 23.8%, 32.8%, and 29.3% for CF, AF, and HF, respectively. The most important cause of failure was inability to control disease at the primary site; however, isolated distant metastasis were observed in 15.4% of all failures. Treatment delays were more common in the HF and CF groups. The highest incidence of late complications occurred in the AF group.


CONCLUSIONS
Advanced lesions of the oropharynx have an ominous prognosis. New fractionation regiments represent a warranted approach as an alternative to or an integration into combined chemotherapy and radiotherapy.
Fallai
C
C
Department of Radiotherapy, Policlinico di Careggi, Florence, Italy.
Olmi
P
P
Cellai
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D017211:Treatment Failure