title: Impact of average weekly dose of radiation during radiotherapy alone or chemoradiotherapy in head and neck cancer.
abstract: BACKGROUND
  Altered fractionated radiotherapy (RT) has been shown to improve locoregional control (LRC) and overall survival (OS) in squamous cell cancer of the head and neck (SCCHN). We investigated patient outcomes using a new parameter: the average weekly dose (AWD).
  
  
  METHODS
  The medical records of 601 patients who received definitive RT for SCCHN were reviewed. AWD was calculated by dividing the total dose in Gray (Gy) by overall treatment time in weeks, and assessed for predictive value.
  
  
  RESULTS
  Various standard RT fractionation schedules were used. An AWD >10.0 Gy was associated with improved LRC at 2 years for patients treated with RT alone (80.9% vs 60.9%; p = .006), but not for those treated with concurrent chemoradiation (75.3% vs 77.3%; p = .77). Nonsignificant increases in late dysphagia were seen with AWD >10.0 Gy.
  
  
  CONCLUSIONS
  An AWD of >10 Gy was found to be beneficial for RT alone regimens but not chemoradiotherapy regimens.
authors: Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors: Aleksandar F
authors: AF
authors: Dragovic
authors: James A
authors: JA
authors: Bonner
authors: Sharon A
authors: SA
authors: Spencer
authors: Lisle M
authors: LM
authors: Nabell
authors: William R
authors: WR
authors: Carroll
authors: Jimmy J
authors: JJ
authors: Caudell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000379:methods*; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult