Continuous accelerated 7-days-a-week radiotherapy for head-and-neck cancer: Long-term results of Phase III clinical trial

Składowski, Krzysztof; Maciejewski, B.; Goleń, M.; Tarnawski, Rafał; Ślosarek, Krzysztof; Suwiński, Rafał; Syguła, M.; Wygoda, A.

doi:10.1016/j.ijrobp.2006.05.026

Cited by 63 publications

(36 citation statements)

References 27 publications

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“…Studies investigating only the impact of acceleration, i.e., the delivery of more than 10 Gy per week that is the norm in conventional fractionation delivered in 5 daily fractions per week, have reported better control, but also an increase in acute reactions and sometimes an increase in late reactions when the interfraction interval was too short to allow full repair of sublethal damage [20,28,29]. More successful were schedules combining hyperfractionation and acceleration by delivering two or more fractions per day [18,22,30,31].…”

Section: Repopulationmentioning

confidence: 99%

The Six Rs of Head and Neck Cancer Radiotherapy

Marcu¹,

Toma-Daşu²,

Daşu³

2015

Contemporary Issues in Head and Neck Cancer Management

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Section: Repopulationmentioning

confidence: 99%

The Six Rs of Head and Neck Cancer Radiotherapy

Marcu¹,

Toma-Daşu²,

Daşu³

2015

Contemporary Issues in Head and Neck Cancer Management

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“…By using the 7 days/week schedule for 5 weeks but decreasing the daily dose from 2.0 Gy to 1.8 Gy in a small controlled trial [27,28], the investigators were able to reduce morbidity to a manageable level and demonstrated a highly significant greater 5-year locoregional tumor control rate of 75% for continuous accelerated irradiation, versus 33% with standard fractionation. One approach that has been examined in clinical trials is the use of short-course, continuous hyperfractionated accelerated radiotherapy (CHART), whereby 36 fractions of radiotherapy are administered three times daily for 12 consecutive days (compared with 5-7 weeks of therapy for most radiotherapy regimens).…”

Section: Radiation Treatment Breaks and Altered Fractionation Schedulesmentioning

confidence: 99%

“…This technique is now being tested in the randomized phase III EPIC multicenter trial in combination with cetuximab [51]. As described previously, outcomes are superior when radiotherapy alone is accelerated on a 7 days/week schedule for a shorter total duration with a lower daily dose [28]. Therefore, the Radiation Therapy Oncology Group (RTOG)-0129 protocol was designed to evaluate the effects of concurrent cisplatin therapy with intensified radiotherapy (70 Gy in 35 fractions given 5 days/week for 7 weeks, versus 72 Gy in 42 fractions given 7 days/week for 6 weeks).…”

Section: Radiation Treatment Breaks and Concurrent Crtmentioning

confidence: 99%

Radiation Treatment Breaks and Ulcerative Mucositis in Head and Neck Cancer

et al. 2008

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Unplanned radiation treatment breaks and prolongation of the radiation treatment time are associated with lower survival and locoregional control rates when radiotherapy or concurrent chemoradiotherapy is used in the curative treatment of head and neck cancer. Treatment of head and neck cancer is intense, involving high-dose, continuous radiotherapy, and often adding chemotherapy to radiotherapy. As the intensity of treatment regimens has escalated in recent years, clinical outcomes generally have improved. However, more intensive therapy also increases the incidence of treatment-related toxicities, particularly those impacting the mucosal lining of the oral cavity, pharynx, and cervical esophagus, and results in varying degrees of ulcerative mucositis. Ulcerative mucositis is a root cause of unscheduled radiation treatment breaks, which prolongs the total radiation treatment time. Alterations in radiotherapy and chemotherapy, including the use of continuous (i.e., 7 days/week) radiotherapy to ensure constant negative proliferative pressure, may improve efficacy outcomes. However, these approaches also increase the incidence of ulcerative mucositis, thereby increasing the incidence of unplanned radiation treatment breaks. Conversely, the reduction of ulcerative mucositis to minimize unplanned breaks in radiotherapy may enhance not only tolerability, but also efficacy outcomes. Several strategies to prevent ulcerative mucositis in radiotherapy for head and neck cancer have been evaluated, but none have demonstrated strong efficacy. Continued investigation is needed to identify superior radiation treatment regimens, technology, and supportive care that reduce unplanned radiation treatment breaks with the goal of improving clinical outcomes in head and neck cancer. The Oncologist 2008;13:886 -898

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“…Yet, they are the cornerstone of the majority of available knowledge on subjective side effects after radiotherapy as they are relatively simple, fast, and cheap to use. The scoring systems are sensitive enough to detect differences in toxicity dependent on volume [27], acceleration [28], fractionation [29], and concomitant chemotherapy [11].…”

Section: Observer-scored Subjective Symptomsmentioning

confidence: 99%

Measuring side effects after radiotherapy for pharynx cancer

Jensen

2007

Acta Oncologica

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Continuous accelerated 7-days-a-week radiotherapy for head-and-neck cancer: Long-term results of Phase III clinical trial

Cited by 63 publications

References 27 publications

The Six Rs of Head and Neck Cancer Radiotherapy

The Six Rs of Head and Neck Cancer Radiotherapy

Radiation Treatment Breaks and Ulcerative Mucositis in Head and Neck Cancer

Measuring side effects after radiotherapy for pharynx cancer

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