Acceleration of hyperfractionated chemoradiation regimen for advanced head and neck cancer.
BACKGROUND
Our aim was to evaluate the acceleration of a hyperfractionated, concurrent chemoradiation regimen (HxCRT) for advanced head and neck squamous cell carcinoma (HNSCC).


METHODS
Patients with unresectable HNSCC were treated based on a previously published HxCRT regimen: 1.25 Gy twice daily to 70 Gy concurrent with cisplatin 12 mg/m(2)/day and 5-fluorouracil 600 mg/m(2)/day for 5 days, weeks 1, 5. This regimen was accelerated in this series by shortening the treatment from 7 to 6 weeks by omitting the planned mid-treatment 1-week break.


RESULTS
Forty-six patients with T3-4/N3 disease were treated. The main acute toxicity was pharyngeal. Median weight change during therapy in patients with and without enteral feeding tubes was -3.8% and -7.9%, respectively (p = .08). Fifteen percent had late grade III pharyngeal toxicity. Local/regional and distant failure rates were 28% and 17%, respectively; 52% are alive without evidence of disease.


CONCLUSIONS
In nonresectable HNSCC, acceleration of the HxCRT regimen is feasible, requiring enteral feeding tubes during therapy in most patients.
Allen
Aaron M
AM
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Elshaikh
Mohamed
M
Worden
Francis P
FP
Bradford
Carol R
CR
Teknos
Theodoros N
TN
Chepeha
Douglas B
DB
Tsien
Christina
C
Dawson
Laura A
LA
Urba
Susan
S
Wolf
Gregory T
GT
Normolle
Daniel
D
Eisbruch
Avraham
A
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001835:Body Weight; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D003680:Deglutition Disorders / Q000139:chemically induced; D019583:Dose Fractionation, Radiation; D004750:Enteral Nutrition; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000139:chemically induced; D011879:Radiotherapy Dosage; D012867:Skin / Q000187:drug effects / Q000528:radiation effects; D016896:Treatment Outcome; D014987:Xerostomia / Q000139:chemically induced
D002945:Cisplatin; D005472:Fluorouracil