title: [Evaluation of mucosal acute radiation injury during accelerated-hyperfractionted split course radiotherapy (CHA-CHA) in advanced head and neck neoplasms].
abstract: The material consisted of 18 patients, a pilot group of randomised study regarding radiotherapy of advanced head and neck cancer with massive lymph nodes metastases using accelerated, hyperfractionated, split-course scheme (CHA-CHA). Patients were irradiated twice a day with 6 hours gap using fraction dose of 1.6 Gy up to dose of 32 Gy. The same course of radiotherapy was repeated after 8 days of gap and treatment was completed within 28 days to avoid accelerated repopulation of tumour clonogens. The aim of the study was to assess the toxicity of treatment. The mucosal acute radiation injury using Dische scale and weight of patients were evaluated. The Severity-Time Units values were calculated and compared to conventional radiotherapy. The average "time-intensity" curves of a radiation reaction and an epitheliolisis were calculated. The reaction had dynamic growth up to 14 points within two weeks. Next two weeks of plateau was observed. The healing phase was three weeks long, but in some cases a value of 4 points was still noted in the 20 week. The heaviest reaction appeared in the cases of oropharyngeal cancer. STU values differed significantly for CHA-CHA and conventional treatment. The big weight loss caused by malnutrition provoked by radiation reaction was found, but it never was a reason of the treatment gap. On the base of obtained results we form the conclusion that CHA-CHA scheme provokes dynamic and intensive radiation reaction which is well tolerated by patients and which is not a reason of consequential late effects.
authors.affiliation: Zakład Radioterapii Centrum Onkologii-Instytutu im. M. Skłodowskiej-Curie, oddział w Gliwicach.
authors.forename: Leszek
authors.initials: L
authors.lastname: Miszczyk
authors.forename: Rafał
authors.initials: R
authors.lastname: Tarnawski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Woźniak
authors.forename: Bogusław
authors.initials: B
authors.lastname: Maciejewski
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000528:radiation effects*; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D020545:Respiratory Mucosa / Q000528:radiation effects*; D013997:Time Factors; D016896:Treatment Outcome