Accelerated Fractionation Radiotherapy in Treating Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma

Abstract

Purpose: Acute toxicity, tumor control and survival outcomes were prospectively evaluated following accelerated fractionation radiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods: Between 2012-2013, patients with non-metastatic HNSCC (T1-2N1 or T3-4N0-1) were accrued to a phase I/II prospective study. All patients were treated with 70 Gy in 30 fractions over 5 weeks (6 fractions/week). Acute toxicity, clinical response, local (LC), regional (RC) and distant control (DC), disease free-(DFS) and overall-survival (OS) were analyzed. Results:In total, 40 patients were enrolled; median follow-up was 41 months. The majority of patients were clinical stage III (n=37, 92.5%), ≥ 50 year (n=34, 85%), and male gender (n=29, 72.5%). Approximately half of the patients had laryngeal cancer. The overall grade 3 acute toxicity was 62.5%; mainly mucositis (n=23, 57.5%) and dysphagia (n=18, 45%). Overall, 34 patients (85%) showed complete response following radiotherapy. Three-year LC, RC, DC, OS and DFS were 81.6%, 85.3%, 90.3%, 64.4% and 58.7%, respectively. Conclusion:Our proposed accelerated fractionation radiotherapy regimen appears feasible and safe. Future research is required to investigate the longer term outcomes including late toxicity with comparison to the standard treatment (i.e. concurrent chemo-radiotherapy).