Effectiveness and toxicity of hypofractionated high-dose intensity-modulated radiotherapy versus 2- and 3-dimensional radiotherapy in incurable head and neck cancer.
This retrospective study evaluates efficacy and tolerability of high-dose hypofractionated radiotherapy (RT) in patients with head and neck cancer.



All patients with head and neck cancer treated between September 2003 and September 2013 with 12 × 4 Gy RT were included. Two and 3D-RT or intensity-modulated radiotherapy (IMRT) were used. Overall survival (OS), tumor response, and palliative effect were evaluated.



Palliative effect occurred in 63% of 81 included patients, lasted a median of 4.6 months, and was correlated with tumor response (p = .006). Median OS was 7.2 months. Confluent mucositis occurred more often in patients treated with 2D/3D-RT than IMRT (26% vs 44%; p = .04) and lasted for a median of 2 weeks.



High-dose hypofractionated RT resulted in meaningful palliation in 63%, lasting for almost 5 months. IMRT should be the technique of choice, as it results in less high-grade toxicity. The 12 × 4 schedule should be opted for patients with reasonable functional capacities and a life expectancy of >6 months. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1264-E1270, 2016.
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Kirsty M
KM
van Beek
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Johannes H A M
JH
Kaanders
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Geert O
GO
Janssens
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Robert P
RP
Takes
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Paul N
PN
Span
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Cornelia G
CG
Verhoef
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000150:complications; D000069473:Radiation Dose Hypofractionation; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies
fractionation; head and neck cancer; intensity-modulated radiotherapy (IMRT); palliation; radiotherapy