Hyperfractionated, accelerated radiotherapy for locally advanced head and neck cancer: quality of life in a prospective phase I/II trial.
OBJECTIVE
Quality of life (QOL) was measured prospectively in a dose escalation study of twice daily hyperfractionated, accelerated radiotherapy for locally advanced head and neck cancer (HNC).


METHODS
Patients with squamous cell HNC (TNM stage III/IV larynx or pharynx, or hypopharynx any stage) received 40 fractions of twice daily RT at 3 dose levels: (L1) 60Gy, 1.5Gy/fraction; (L2) 62Gy, 1.55Gy/fraction; and (L3) 64Gy, 1.6Gy/fraction. QOL was measured on the FACT-H&N at baseline, 6 and 12 months.


RESULTS
Mean QOL scores were: baseline 104, 6 months 108, 12 months 112. At all time points, QOL scores were lower in patients with more advanced T-category. A mixed-model analysis of determinants of QOL showed no dose effect among L1 (n=22), L2 (n=26) or L3 (n=123). QOL improved significantly with time from diagnosis, however post-treatment QOL was lower and improved more slowly in patients who had feeding tubes.


CONCLUSIONS
Post-RT QOL improved from baseline by a statistically and clinically significant amount. Hyperfractionated, accelerated RT provides favorable QOL outcomes, and is a viable alternative to chemoradiation for patients with locally advanced HNC.
Ringash
Jolie
J
Department of Radiation Oncology, The Princess Margaret Hospital, Toronto, Canada. jolie.ringash@rmp.uhn.on.ca
Lockwood
Gina
G
O'Sullivan
Brian
B
Warde
Padraig
P
Bayley
Andrew
A
Cummings
Bernard
B
Kim
John
J
Sellmann
Susanna
S
Waldron
John
J
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000523:psychology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000523:psychology / Q000532:radiotherapy*; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome