Feasibility and Efficacy of Accelerated Weekly Concomitant Boost Postoperative Radiation Therapy Combined with Concomitant Chemotherapy in Patients with Locally Advanced Head and Neck Cancer

Abstract

Reducing overall treatment time using accelerated PORT/CT by weekly concomitant boost (six fractions per week) combined with concomitant cisplatin CT is easily feasible with acceptable morbidity.

Evaluation of purely accelerated six fractions per week radiotherapy in postoperative oral cavity squamous cell carcinoma

“…have reported confluent OM to be 62%, 69%, and 84%, respectively. Grade 3 or more skin toxicity was seen in 15‐29% cases in various studies . Our study had an acute skin toxicity rate of 17.5%, which is consistent with the literature and it appeared in the third and fourth weeks in most of the cases.…”

“…Our study had an acute skin toxicity rate of 17.5%, which is consistent with the literature and it appeared in the third and fourth weeks in most of the cases. Grade 3 dysphagia has been reported in the range of 10‐33% cases in different studies . We found grade 3 pharynx and esophageal toxicity in 25% cases, which started during the third week of treatment.…”

“…The appropriate dose, fractionation, and OTTs for different risk categories of postoperative OCSCC patients continue to be a matter of scientific deliberation and evaluation. Treatment intensification has been attempted in postoperative OCSCC by different methods, including accelerated PORT by concomitant boost techniques, using acceleration with CTRT, split‐course RT, and IMRT techniques (Table ). Although there are several published studies on acceleration in PORT with or without chemotherapy, there is lack of literature addressing purely accelerated PORT.…”

“…However, this approach has been evaluated in de novo pharyngeal and laryngeal head and neck squamous cell carcinoma (HNSCC) patients requiring definitive RT. Some studies have evaluated the role of modest acceleration of RT in postoperative patients of HNSCC. However, they have either used a mixed variety of HNSCCs, or used a concomitant boost regimen as a second fraction on the 5th treatment day and/or allowed the use of simultaneous integrated boost intensity modulated RT (SIB‐IMRT).…”

Systematic review of postoperative therapy for resected squamous cell carcinoma of the head and neck: Executive summary of the American Radium Society appropriate use criteria

“…The rate of DM did not differ between arms. Subsequent single arm phase II studies showed the regimen could be combined with a postoperative accelerated weekly concomitant boost regimen 74 and could be tolerated by populations outside of North America and Europe, such as in Japan. 67,73 Two trials compared weekly dosing of cisplatin with PORT compared to PORT-alone in patients with stage III/IV SCCHN.…”