Continuous hyperfractionated accelerated radiotherapy with/without mitomycin C in head and neck cancer

Area of Science:

• Radiation Oncology
• Medical Oncology

Background:

• Head and neck squamous cell carcinoma (HNSCC) presents significant treatment challenges.
• Conventional fractionation radiotherapy (CF) is a standard treatment, but prolonged treatment times can impact outcomes.

Purpose of the Study:

• To evaluate the efficacy of an accelerated hyperfractionated radiation therapy (V-CHART) with or without mitomycin C (MMC) compared to conventional fractionation (CF) for HNSCC.
• To assess the impact of a shortened treatment schedule on tumor control and patient survival.

Main Methods:

• 188 patients with histologically verified HNSCC were randomized into three arms: CF, V-CHART, or V-CHART + MMC.
• V-CHART delivered 55.3 Gy in 33 fractions over 17 days, with twice-daily fractions.
• MMC was administered at 20 mg/sqm on day 5 of the V-CHART regimen.

Main Results:

• Complete response rates were 43% (CF), 58% (V-CHART), and 67% (V-CHART + MMC).
• Local tumor control rates were 28% (CF), 32% (V-CHART), and 56% (V-CHART + MMC).
• V-CHART + MMC showed significantly improved actuarial survival and local tumor control compared to CF and V-CHART alone.

Conclusions:

• Accelerated hyperfractionated radiation therapy (V-CHART) allows for dose reduction while maintaining local tumor control compared to CF.
• The addition of mitomycin C to the V-CHART regimen is tolerable and significantly improves treatment outcomes for HNSCC patients.
• Shortening overall treatment time in HNSCC radiotherapy is feasible and beneficial when combined with appropriate chemotherapy.