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Therapy Testing in a Spheroid-based 3D Cell Culture Model for Head and Neck Squamous Cell Carcinoma
Published on: April 20, 2018
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Hypofractionated radiotherapy for head and neck squamous cell carcinoma
Dylan Bocha1, Jennifer Le Guevelou2, Cécile Ortholan3
1Département de radiothérapie, Sainte-Catherine Institut du cancer Avignon-Provence, 250, chemin de Baigne-Pieds, 84918 Avignon, France.
Summary
Hypofractionated radiotherapy offers a shorter, potentially more tolerable treatment for head and neck squamous cell carcinoma. While promising in specific cases like early glottic cancer and elderly patients, further research is needed to confirm its long-term effectiveness and safety.
Area of Science:
- Radiation Oncology
- Head and Neck Cancer Research
- Clinical Trials
Background:
- Standard treatment for head and neck squamous cell carcinoma (HNSCC) includes surgery, radiotherapy, and chemotherapy.
- Normofractionated radiotherapy with concurrent chemotherapy is the current standard of care for HNSCC.
- Hypofractionated radiotherapy, involving fewer but larger radiation doses, is being explored to shorten treatment duration and improve patient adherence.
Purpose of the Study:
- To evaluate the feasibility, efficacy, and toxicity of hypofractionated radiotherapy in various clinical settings for HNSCC.
- To review existing evidence on hypofractionated radiotherapy for HNSCC, including early-stage disease, elderly patients, and palliative care.
Main Methods:
- Review of recent clinical trials and studies investigating hypofractionated radiotherapy in HNSCC.
- Analysis of data from randomized trials (e.g., HYPNO, HYPORT, JCOG0701, ELAN-RT) and phase I-II studies.
- Examination of hypofractionated regimens in exclusive, postoperative, early glottic, elderly, and palliative HNSCC contexts.
Main Results:
- Hypofractionated radiotherapy has shown feasibility and non-inferiority compared to standard schedules in some HNSCC studies (e.g., HYPNO, HYPORT).
- Moderate hypofractionation is effective for early glottic cancers (T1-T2), demonstrating non-inferior disease control and acceptable toxicity (JCOG0701).
- Stereotactic body radiotherapy shows promise for glottic carcinoma, and split-course hypofractionation is well-tolerated in elderly patients (ELAN-RT).
- Hypofractionated regimens provide effective symptom control in palliative HNSCC settings.
Conclusions:
- Hypofractionated radiotherapy is a promising strategy for selected HNSCC cases, including early glottic cancer, elderly patients, and palliative care.
- Current evidence suggests non-inferiority in disease control and acceptable toxicity in specific contexts.
- Further prospective randomized studies are essential to establish optimal indications, long-term outcomes, and safety profiles for hypofractionated radiotherapy in HNSCC.
