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Continuous hyperfractionated accelerated radiotherapy in advanced head and neck malignancies

H R Mali1, N Tandon, G N Aggarwal

  • 1Department of Radiotherapy, K. G's Medical College, Lucknow, UP, India.

Indian Journal of Cancer
|December 16, 1998
PubMed
Summary

Continuous hyperfractionated accelerated radiotherapy significantly improved tumor regression in advanced head and neck cancer patients. This advanced radiotherapy technique showed higher complete regression rates compared to conventional methods.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Head and Neck Cancer Research

Background:

  • Advanced head and neck cancers present significant treatment challenges.
  • Conventional radiotherapy has limitations in achieving complete tumor control for advanced stages.
  • Optimizing radiotherapy schedules is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of continuous hyperfractionated accelerated radiotherapy (CHART) in advanced head and neck cancer.
  • To compare tumor regression rates between CHART and conventional radiotherapy.
  • To assess treatment-related toxicity and clinical outcomes in patients receiving CHART.

Main Methods:

  • A study involving 58 patients with advanced head and neck cancer, divided into a study group (29 patients) and a control group (29 patients).

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  • The study group received CHART: 1.5 Gy, 3 times daily, 36 fractions over 12 days, with a 6-hour interfraction interval and a spinal cord dose of 40.5 Gy.
  • The control group received conventional radiotherapy.

    • Main Results:

    • CHART demonstrated significantly higher complete regression rates (79.13%) compared to conventional radiotherapy (P < 0.001).
    • Tumor control rates were 90% for Stage III and 73.68% for Stage IV disease with CHART.
    • Severe acute mucosal reactions (Grade III) occurred in 62.06% of CHART patients, necessitating nasogastric feeding in 25.92%.

    Conclusions:

    • Continuous hyperfractionated accelerated radiotherapy is an effective treatment for advanced head and neck cancer, yielding superior tumor control.
    • While effective, CHART is associated with severe acute mucosal toxicity, requiring careful patient management.
    • Further research into managing CHART-induced toxicities may enhance its clinical applicability.