[Intensity Modulated Hyperfractionated Accelerated Radiotherapy to Treat Advanced Head and Neck Cancer - Predictive...

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer Research

Background:

• Patients with locally advanced head and neck cancers often have limited treatment options, especially if ineligible for chemotherapy.
• Hyperfractionated accelerated radiotherapy schedules with simultaneous integrated boost offer a potential treatment strategy for these patients.

Purpose of the Study:

• To evaluate the overall survival (OS) outcomes in patients with head and neck cancer treated with a hyperfractionated accelerated radiotherapy schedule.
• To identify prognostic factors influencing overall survival in this patient cohort.

Main Methods:

• A cohort of 122 patients with locally advanced, nonmetastatic squamous laryngeal, hypopharyngeal, oropharyngeal, and oral cavity cancers were treated.
• Patients received radiotherapy with a median total dose of 72.6 Gy, delivered twice daily.
• Overall survival was analyzed using the Kaplan-Meier method, and prognostic factors were assessed with Cox regression.

Main Results:

• The 1- and 2-year overall survival rates were 65% and 32%, respectively.
• Grade 3 acute toxicity was observed in 62% of patients, primarily mucositis, with no grade 4 or 5 toxicities.
• Negative prognostic factors for OS included Karnofsky Performance Status (KPS) less than 80%, cancers other than oropharyngeal or laryngeal, and high gross tumor volume (GTV).

Conclusions:

• A significant proportion of patients with poor prognostic factors survived beyond 2 years.
• Karnofsky Performance Status (KPS) before treatment emerged as the most critical prognostic factor for improved overall survival (OS).
• Hyperfractionated accelerated radiotherapy is a viable treatment option for head and neck cancer patients ineligible for chemotherapy.