PURPOSE: To evaluate the feasibility and efficacy of a hyperfractionated accelerated radiotherapy (RT) schedule combined with concomitant chemotherapy (Cx) in patients with locally advanced head-and-neck squamous cell carcinoma. METHODS AND MATERIALS: Between 2004 and 2007, a total of 90 patients with locoregionally advanced head-and-neck squamous cell carcinoma underwent irradiation according to a hybrid fractionation schedule consisting of 20 fractions of 2 Gy (once daily) followed by 20 fractions of 1.6 Gy (twice daily) to a total dose of 72 Gy. Concomitant Cx (cisplatinum 100 mg/m(2)) was administered at the start of Weeks 1 and 4. Treatment outcome and toxicity were retrospectively compared with a previous patient group (n = 73) treated with the same schedule, but without concomitant Cx, between 2001 and 2004. RESULTS: The locoregional control (LRC) rate was 70% after 2 years. Two-year overall and 2-year disease-free survival rates were 74% and 60%, respectively. In comparison with the RT-only group, an improvement of 15% in both LRC (p = 0.03) and overall survival (p = 0.09) was observed. All patients were treated to full radiation dose according to protocol, although the Cx schedule had to be adjusted in 12 patients. No acute Grade 4 or 5 toxicity was seen, but incidences of Grade 3 acute mucositis (74.5% vs. 50.7%; p = 0.002) and dysphagia (82.2% vs. 47.9%; p < 0.001) were significantly higher in the chemoradiotherapy group compared with patients treated with RT alone. CONCLUSION: With this chemoradiotherapy regimen, excellent LRC and survival rates were achieved, with acceptable acute toxicity.
PURPOSE: To evaluate the feasibility and efficacy of a hyperfractionated accelerated radiotherapy (RT) schedule combined with concomitant chemotherapy (Cx) in patients with locally advanced head-and-neck squamous cell carcinoma. METHODS AND MATERIALS: Between 2004 and 2007, a total of 90 patients with locoregionally advanced head-and-neck squamous cell carcinoma underwent irradiation according to a hybrid fractionation schedule consisting of 20 fractions of 2 Gy (once daily) followed by 20 fractions of 1.6 Gy (twice daily) to a total dose of 72 Gy. Concomitant Cx (cisplatinum 100 mg/m(2)) was administered at the start of Weeks 1 and 4. Treatment outcome and toxicity were retrospectively compared with a previous patient group (n = 73) treated with the same schedule, but without concomitant Cx, between 2001 and 2004. RESULTS: The locoregional control (LRC) rate was 70% after 2 years. Two-year overall and 2-year disease-free survival rates were 74% and 60%, respectively. In comparison with the RT-only group, an improvement of 15% in both LRC (p = 0.03) and overall survival (p = 0.09) was observed. All patients were treated to full radiation dose according to protocol, although the Cx schedule had to be adjusted in 12 patients. No acute Grade 4 or 5 toxicity was seen, but incidences of Grade 3 acute mucositis (74.5% vs. 50.7%; p = 0.002) and dysphagia (82.2% vs. 47.9%; p < 0.001) were significantly higher in the chemoradiotherapy group compared with patients treated with RT alone. CONCLUSION: With this chemoradiotherapy regimen, excellent LRC and survival rates were achieved, with acceptable acute toxicity.
Authors: Vincent Vandecaveye; Piet Dirix; Frederik De Keyzer; Katya Op de Beeck; Vincent Vander Poorten; I Roebben; Sandra Nuyts; Robert Hermans Journal: Eur Radiol Date: 2010-02-24 Impact factor: 5.315
Authors: F Arias; G Asín; M I Uzcanga; E Maraví; I Quílez; V Chicata; C Eito; A Viudez; I Hernández; F Mañeru; M A Domínguez Journal: Clin Transl Oncol Date: 2013-11-08 Impact factor: 3.405
Authors: L Miszczyk; B Maciejewski; A Tukiendorf; G Woźniak; B Jochymek; A Gawryszuk; M Szweda Journal: Br J Radiol Date: 2014-07-16 Impact factor: 3.039
Authors: Patrick D Maguire; Michael Papagikos; Sue Hamann; Charles Neal; Martin Meyerson; Neil Hayes; Peter Ungaro; Kenneth Kotz; Marion Couch; Hoke Pollock; Joel Tepper Journal: Int J Radiat Oncol Biol Phys Date: 2010-04-08 Impact factor: 7.038