Tolerability and efficacy of simultaneously integrated boost radiotherapy in head and neck cancer treatment

Radiotherapy (RT) plays a crucial role in managing head and neck tumors. A key challenge is balancing optimal tumor control with the preservation of healthy tissues. Our study aimed to evaluate the key benefits and complications of head and neck RT using simultaneously integrated boost (SIB) compared to conventional fractionation.

This study included patients with head and neck cancers who received definitive or postoperative RT between September 2022 and October 2023 at the Department of Oncotherapy, University of Szeged. A total of 66 patients were analyzed, with 33 receiving SIB and 33 treated with sequential boost (SB). All patients underwent adaptive RT with or without concurrent cisplatin or cetuximab therapy. Demographic and pathological data were comparable between the groups. Acute toxicities, local control outcomes at three months post-RT, and tumor volume changes at two-thirds of the RT course were assessed.

No significant differences were observed in dysphagia, radiomucositis, and xerostomia between the two groups. The incidence of grade 2-3 radiodermatitis was significantly higher in the SB group (42.4% vs. 15.6%; p = 0.01). and therapeutic breaks were more frequent with SB compared to SIB. There was no significant difference in local tumor response rates between the groups during and after the RT. Biological effective dose (BED) calculations suggest a slightly lower probability of late side effects with the SIB technique.

The SIB technique can be safely and effectively used in head and neck RT, offering reduced acute skin toxicity and maintaining proper tumor response. These early results indicate that SIB is a favorable option for managing head and neck cancers.