[Accelerated hyperfractionated simultaneous radiochemotherapy in advanced head-neck carcinomas in comparison: split...

Area of Science:

• Oncology
• Radiotherapy
• Head and Neck Cancer Treatment

Background:

• Advanced squamous cell carcinomas of the head and neck present significant treatment challenges.
• Optimizing radiochemotherapy regimens is crucial for improving patient outcomes and tolerability.

Purpose of the Study:

• To compare the efficacy and toxicity of accelerated hyperfractionated split-course radiochemotherapy (SCRC) versus concomitant-boost radiochemotherapy (CBRC) in patients with advanced head and neck cancer.
• To evaluate patient acceptance and treatment delays associated with each regimen.

Main Methods:

• Retrospective analysis of two patient cohorts treated between 1989-1994.
• Cohort 1 (n=38): SCRC with cisplatin/5-FU/Leucovorin over 51 days (70.2 Gy).
• Cohort 2 (n=50): CBRC with carboplatin over 33 days (66 Gy).

Main Results:

• SCRC treatment was delayed in ~50% of patients due to toxicity, primarily mucositis (WHO grade >3 in up to 15/38 patients).
• CBRC treatment was delayed in ~7.5% of patients, with mucositis also being a major factor (WHO grade >3 in 50% of patients).
• CBRC exhibited lower overall toxicity and better patient compliance compared to SCRC.

Conclusions:

• Concomitant boost radiochemotherapy (CBRC) is associated with lower toxicity and higher patient acceptance than split-course radiochemotherapy (SCRC).
• These findings suggest CBRC may lead to improved treatment adherence and potentially better two-year survival rates.