title: Accelerated fractionation head and neck intensity-modulated radiation therapy and concurrent chemotherapy in the community setting: safety and efficacy considerations.
abstract: BACKGROUND
  This article reviews our community cancer center's experience treating head and neck cancer primarily with accelerated fractionation intensity-modulated radiation therapy (IMRT), with or without concurrent chemotherapy, focusing on acute toxicity and efficacy.
  
  
  METHODS
  Fifty-two patients treated with IMRT at the Penrose Cancer Center between 2002 and 2007 constitute the cohort. The majority (75%) received an accelerated, altered fractionation regimen, typically concomitant boost to 7200 cGy. Concurrent chemotherapy was delivered to 32 (62%). The median follow-up was 24 months.
  
  
  RESULTS
  The 2-year actuarial rates of local control, regional control, and distant metastasis-free survival were 100%, 91%, and 94%, respectively. Relapse-free survival and overall survival at 2 years were 89% and 91%, respectively. Overall, 32 of 52 patients (62%) experienced at least 1 type of grade 3 or 4 acute toxicity.
  
  
  CONCLUSIONS
  Accelerated fractionation IMRT, with or without chemotherapy, can be given safely and effectively in a community cancer center setting.
authors.affiliation: Penrose Cancer Center, Department of Radiation Oncology, Colorado Springs, Colorado, USA. dralmonroe@yahoo.com
authors.forename: Alan T
authors.initials: AT
authors.lastname: Monroe
authors.forename: James A
authors.initials: JA
authors.lastname: Young
authors.forename: Jason D
authors.initials: JD
authors.lastname: Huff
authors.forename: Joel A
authors.initials: JA
authors.lastname: Ernster
authors.forename: Gerald A
authors.initials: GA
authors.lastname: White
authors.forename: Anuj V
authors.initials: AV
authors.lastname: Peddada