Split-course accelerated hyperfractionation (CHA-CHA) for advanced head and neck cancers -- preliminary results

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer Research

Background:

• Advanced oral cavity, oro-hypopharynx, and larynx cancers present significant treatment challenges.
• Conventional radiotherapy regimens may have limitations in achieving optimal tumor control and survival outcomes.

Purpose of the Study:

• To evaluate the toxicity and effectiveness of a novel radiotherapy schedule: split-course, accelerated hyperfractionation with a planned gap (CHA-CHA).
• To assess treatment outcomes based on pilot data from patients with advanced head and neck cancers.

Main Methods:

• A cohort of 27 patients with advanced (T2N2c-3, T3-4N2) head and neck cancers received CHA-CHA radiotherapy.
• Radiation dose: 1.6 Gy per fraction, twice daily with a 6-hour gap, totaling 64 Gy in 28 days, with an 8-day mid-treatment gap.
• Toxicity (mucositis via Dische scale), tumor/nodal regression, and survival were assessed. Correlations between clinical factors and outcomes were analyzed.

Main Results:

• High but acceptable mucositis intensity was observed, peaking in the 4th week (mean 15 Dische points).
• Complete response (CR) rates were 54.5% for tumors and 57.1% for nodes.
• Four-year overall survival (OS) was 35%, and survival excluding distant metastases was 38%.

Conclusions:

• The CHA-CHA radiotherapy regimen appears to be a potentially valid method for treating advanced head and neck cancers.
• Significant correlations were found between hemoglobin levels, tumor/nodal size, performance status, and treatment outcomes.
• Further validation through randomized trials is recommended to confirm the efficacy of CHA-CHA.