Preliminary results in advanced head and neck cancer with radiotherapy by multiple fractions a day

Nine patients with advanced head and neck cancer have been treated by irradiation consisting of three fractions a day of 180 rad administered with intervals of 4 h. The total dose was 4860--5400 rad in an overall time of 11--12 days. The acute mucosal reactions produced by this multifractionated schedule were similar to those observed with conventional fractionation. The acute skin reactions were minimal. The period of acute reactions were shorter than is generally observed with conventional fractionation. In six patients with a follow-up time of six months or longer no late reactions have been detected with the exception of one patient requiring permanent tracheostomy because of laryngeal oedema. In the whole group of patients loco-regional control of the disease has been achieved. Six patients have maintained the full response for six months or longer. The results so far obtained with this multiple fractions a day schedule are encouraging. More patients have to be entered in this study in order to draw definitive conclusions.