Early experience with a hybrid accelerated radiotherapy schedule for locally advanced head and neck cancer.
BACKGROUND
Our aim was to determine feasibility and efficacy of a hybrid radiotherapy schedule in locally advanced head and neck cancer.


METHODS
Seventy-three patients with locally advanced head and neck cancer were irradiated according to a hybrid accelerated schedule consisting of 20 fractions of 2 Gy (once daily), followed by 20 fractions of 1.6 Gy (twice daily), to a total dose of 72 Gy.


RESULTS
Locoregional control was 55% after 2 years. Overall survival was 59%, disease-specific survival was 63%, and disease-free survival was 46%. Acute toxicity was prospectively scored in all 73 patients: the most frequent toxicities were mucositis (50.7%, grade 3), dysphagia (47.9%, grade 3), and dermatitis (34.5%, grade 3). All patients were treated to full dose, without treatment interruption.


CONCLUSIONS
With this regimen, acceptable locoregional control and survival rates are achieved. Toxicity was well manageable, suggesting that a combination of this schedule with concomitant chemotherapy is possible and could lead to further improvement in the treatment of locally advanced head and neck cancer.
Nuyts
Sandra
S
Department of Radiation Oncology, Leuvens Kanker Instituut (LKI), University Hospital Gasthuisberg, Leuven, Belgium.
Dirix
Piet
P
Hermans
Robert
R
Poorten
Vincent Vander
VV
Delaere
Pierre
P
Weltens
Caroline
C
Van den Bogaert
Walter
W
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001530:Belgium; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D011881:Radiotherapy, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome