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Comparison between continuous accelerated hyperfractionated and late-course accelerated hyperfractionated
Yang Wang1, Xue-Hui Shi, Shao-Qin He
1Department of Radiation Oncology, Cancer Hospital of Medical Center, Fudan University, Shanghai, P.R. China. wangyangdoctor@eastday.com
International Journal of Radiation Oncology, Biology, Physics
|August 17, 2002
Summary
Continuous accelerated hyperfractionated (CAHF) radiotherapy and late-course accelerated hyperfractionated (LCAF) radiotherapy show similar survival rates for esophageal cancer. CAHF leads to more severe acute esophagitis, suggesting LCAF may be better tolerated.
Area of Science:
- Oncology
- Radiation Oncology
- Clinical Trials
Background:
- Esophageal carcinoma treatment often involves radiotherapy.
- Optimizing radiotherapy fractionation is crucial for improving outcomes and reducing toxicity.
Purpose of the Study:
- To compare treatment efficacy and toxicity between continuous accelerated hyperfractionated (CAHF) and late-course accelerated hyperfractionated (LCAF) radiotherapy for esophageal carcinoma.
Main Methods:
- 101 patients with squamous cell carcinoma of the esophagus were randomized to CAHF or LCAF radiotherapy.
- CAHF involved 1.5 Gy/fraction b.i.d. to 66 Gy in 44 fractions over 4.4 weeks.
- LCAF involved conventional fractionation followed by accelerated fractionation, totaling 68.4 Gy in 41 fractions over 6.4 weeks.
Main Results:
- No significant difference in local control or survival rates between CAHF and LCAF groups at 1, 2, or 3 years.
- CAHF group experienced significantly higher rates of severe acute esophagitis (p < 0.001).
- Age and lesion length were significant prognostic factors for local control, while age predicted overall survival.
Conclusions:
- CAHF and LCAF yield comparable long-term outcomes for esophageal cancer.
- LCAF appears to be better tolerated due to lower rates of severe acute esophagitis compared to CAHF.
- Both CAHF and LCAF regimens demonstrated superior results compared to historical conventional radiotherapy.
