title: Radiation-free weekend rescued! Continuous accelerated irradiation of 7-days per week is equal to accelerated fractionation with concomitant boost of 7 fractions in 5-days per week: report on phase 3 clinical trial in head-and-neck cancer patients.
abstract: OBJECTIVE
  To report long-term results of randomized trial comparing 2 accelerated fractionations of definitive radiation therapy assessing the need to irradiate during weekend in patients with head and neck squamous cell carcinoma.
  
  
  METHODS
  A total of 345 patients with SCC of the oral cavity, larynx, and oro- or hypo-pharynx, stage T2-4N0-1M0, were randomized to receive continuous accelerated irradiation (CAIR: once per day, 7 days per week) or concomitant accelerated boost (CB: once per day, 3 days per week, and twice per day, 2 days per week). Total dose ranged from 66.6-72 Gy, dose per fraction was 1.8 Gy, number of fractions ranged from 37-40 fractions, and overall treatment time ranged from 37-40 days.
  
  
  RESULTS
  No differences for all trial end-points were noted. At 5 and 10 years, the actuarial rates of local-regional control were 63% and 60% for CAIR vs 65% and 60% for CB, and the corresponding overall survival were 40% and 25% vs 44% and 25%, respectively. Confluent mucositis was the main acute toxicity, with an incidence of 89% in CAIR and 86% in CB patients. The 5-year rate of grade 3-4 late radiation morbidity was 6% for both regimens.
  
  
  CONCLUSIONS
  Results of this trial indicate that the effects of accelerated fractionation can be achieve by delivering twice-per-day irradiation on weekday(s). This trial has also confirmed that an accelerated, 6-weeks schedule is a reasonable option for patients with intermediate-stage head-and-neck squamous cell carcinoma because of the associated high cure rate and minimal severe late toxicity.
authors: Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Branch in Gliwice, Poland. skladowski@io.gliwice.pl
authors: Krzysztof
authors: K
authors: Skladowski
authors: Marcin
authors: M
authors: Hutnik
authors: Andrzej
authors: A
authors: Wygoda
authors: Maria
authors: M
authors: Golen
authors: Boleslaw
authors: B
authors: Pilecki
authors: Wieslawa
authors: W
authors: Przeorek
authors: Tomasz
authors: T
authors: Rutkowski
authors: Beata
authors: B
authors: Lukaszczyk-Widel
authors: Alicja
authors: A
authors: Heyda
authors: Rafal
authors: R
authors: Suwinski
authors: Rafal
authors: R
authors: Tarnawski
authors: Boguslaw
authors: B
authors: Maciejewski
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology; D011832:Radiation Injuries / Q000453:epidemiology / Q000473:pathology; D013280:Stomatitis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D013997:Time Factors; D047368:Tumor Burden