Preliminary results using twice-a-day fractionation in the radiotherapeutic management of advanced cancers of the head and neck

S, Jampolis; Pipard, G; Horiot, Jean-Claude; Bolla, M.; Dorze, Claire Le

doi:10.2214/ajr.129.6.1091

Cited by 34 publications

(4 citation statements)

References 3 publications

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“…[9][10][11] In our study, a delayed accelerated fractionation scheme was used (concomitantboost technique) in an effort to address the concept of accelerated repopulation. [12][13][14][15][16][17] This report updates our experience.…”

supporting

confidence: 80%

A prospective phase ii trial of concomitant chemotherapy and radiotherapy with delayed accelerated fractionation in unresectable tumors of the head and neck

et al. 1998

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supporting

confidence: 80%

A prospective phase ii trial of concomitant chemotherapy and radiotherapy with delayed accelerated fractionation in unresectable tumors of the head and neck

et al. 1998

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“…With follow up Rodney et al 12 reported local control of 38% for T4 lesions treated with hyperfractionation. Jampoli S et al 20 has observed higher complete response for T4 disease (72%) in the hyperfractionated arm. The overall response rate in the studies with hyperfractionated radiation and chemotherapy ranged from 63.5% 13 -to 92.5% 14 with better response for T3 lesions and modest response for T4 lesions.…”

Section: Discussionmentioning

confidence: 93%

“…18 With concurrent chemotherapy and radiation, in a study by Marcial et al 19 observed a complete response 68% of patients with T3 disease. Jampoli S et al 20 has observed higher complete response for T4 disease. With follow up Rodney et al 12 reported local control of 38% for T4 lesions treated with hyperfractionation.…”

Section: Discussionmentioning

confidence: 94%

“…15 Jampolis et alin advanced lesions of the head and neck has used 120 cGy B/D up to a total of 70 Gy. 16 Parson et al observed severe mucositis in 20% of patients which markedly interfered with the ability to maintain adequate nutrition, with 15 patients having to put ryles tube. 17 According to Parsonetal tolerance to hyperfractionated radiation improved with limiting the volume that receives the full dose by shrinking the fields, differential weight age and wedges.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Locoregional Control, Acute Radiation Toxicities and Patient Compliance between Two Different Radiation Fractionation Schedules with Concurrent Chemotherapy in Oropharyngeal Cancer

Binesh¹,

C.K²,

C.C³

et al. 2018

IJCMR

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Introduction: Irrespectively of the modality of primary treatment for head and neck squamous cell carcinoma, local or locoregional residual or recurrent tumors represent the major cause of treatment failure, emphasizing the role of locoregional control for the patients' long-term survival. The study compares HFRT-CT and CTRT in stage III and IV carcinoma of oropharynx. Material and Methods: Study arm (HFRT-CT) 1.1 Gy per fraction, two fractions daily with a minimum interfraction interval of 6 hours, five days a week up to a total dose of 72.6 Gy in 66 fractions over 6-6 1/2 weeks and in the control arm (CTRT) 2 Gy per fraction, single fraction a day, five days a week to a total of 66Gy, over 6-6 ½ weeks, both the arms use concurrent chemotherapy with injection cisplatin 40mg/ m2 weekly. Results: At the end of 6 th week 28 patients in the HFRT-CT arm and 29 patients in CTRT arm were available for evaluation. In the HFRT-CT arm 24/28(85.7%)patients and in the CTRT arm 21/29(72.4%)patients showed complete response for primary. For nodal disease a complete response of 92.85% and 89.65% were seen in HFRT-CT and CTRT arm respectively. At the 6 th week out of the 16 stage III patients in the HFRT-CT arm 13 had complete response(81.3%) and 3 patients had a partial response (18.7%) and out of the 12 stage IV patients 9 patients had a complete response and 3 patients had partial response. Conclusion: Hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced carcinoma, can be delivered with manageable toxicities. A trend towards better outcome for patients having T4 or N3 disease is noted, even though a statistical significance could not be seen.

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Inflammatory breast carcinoma treated by radical radiotherapy

Chu

Wood

Doucette

1980

Cancer

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Sixty-two patients with localized clinical inflammatory breast carcinoma were treated with curative, radical radiotherapy doses to the breast and draining lymphatics at Massachusetts General Hospital from January 1960 to December 1977. Fifty patients have died from disease, 7 are alive with disease, and 5 are free of disease at time of reporting, thus indicating the fulminant nature of this rare form of breast cancer. Median survival is approximately 18 months (mean 24 months). A five-year actuarial survival relapse-free survival of 14% and 6%, respectively, are obtained. Local and regional recurrence was noted in 43 of 62 patients (69%). Twelve patients (19%) failed in the locally irradiated area only, 31 patients (50%) failed in both local, regional, and distant sites, and 14 patients (23%) failed with distant metastases only. Due to the complex dosimetry required in the treatment of breast cancer, retrospective analysis was made of actual tumor doses delivered before 1972. The breast was oftentimes calculated to receive 20 to 35% less than the stated dose. This gave the unique opportunity of observing a dose response relationship in local control within the same institution. Doses in excess of 6000 rads tumor dose seem necessary since 14 of the 15 patients with persistent disease had received less than this dose. However, once tumor exceeded 10 cm, increasing dose within clinical therapeutic ranges failed to control disease, although the recurrence-free interval was somewhat prolonged. Since 1976, twice-a-day fractionation has been used in larger tumors, and this appears to have decreased the local recurrence rate to 33% (2/6) patients. Preliminary results of adjuvant multiple drug therapy, e.g., modified Cooper regimen (CMFVP) or the CMF regime appear encouraging.

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Preliminary results using twice-a-day fractionation in the radiotherapeutic management of advanced cancers of the head and neck

Cited by 34 publications

References 3 publications

A prospective phase ii trial of concomitant chemotherapy and radiotherapy with delayed accelerated fractionation in unresectable tumors of the head and neck

A prospective phase ii trial of concomitant chemotherapy and radiotherapy with delayed accelerated fractionation in unresectable tumors of the head and neck

Comparison of Locoregional Control, Acute Radiation Toxicities and Patient Compliance between Two Different Radiation Fractionation Schedules with Concurrent Chemotherapy in Oropharyngeal Cancer

Inflammatory breast carcinoma treated by radical radiotherapy

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