Preliminary results using twice-a-day fractionation in the radiotherapeutic management of advanced cancers of the head and neck.

Twenty-four cases of advanced T4 cancers of the head and neck were treated using a twice-a-day treatment fractionation delivering a 1,200 rad weekly tumor dose and 7,000 rad total tumor dose in 5 1/2-6 weeks. Acute normal mucosal reactions and skin reactions were plotted weekly and corresponded to reactions observed when delivering 1,000 rad per week in five treatment sessions. Chronic problems have been limited to severe neck fibrosis appearing in three of five patients who underwent a planned neck dissection 6 weeks after the completion of radiotherapy. Local control was observed in 14 of 23 patients (61%) and regional control in 22 of 23 patinets (96%).