Сибирский онкологический журнал (Feb 2016)
ACCELERATED HYPERFRACTIONATED DAY DOSE CHART CHEMORADIATION TREATMENT OF PATIENTS WITH CANCER OF OROPHARYNX AND ORAL CAVITY
Abstract
The main treatment failures of cancer of the oropharynx and oral cavity are associated with the treatment of advanced (III–IV) stages of the disease, incidence of which is extremely high. The treatment toxicity increases and quality of life reduces with increasing aggressiveness of anticancer therapy. Therefore, the search for conservative treatment methods in order to achieve optimal treatment efficacy remains relevant. The study included 233 patients with primary cancer of the oropharynx and oral cavity, who underwent concurrent chemoradiotherapy with accelerated hyperfractionated radiation and standard radiation therapy. In patients who received chemoradiotherapy with accelerated hyperfractionated radiation in the regimens of 1 Gy + 1.5 Gy and 1 Gy+2 Gy with a 4–6 hour interval, 60 Gy total dose, the objective response rate (complete + partial regressions) was significantly higher than that observed in patients who received the standard radiotherapy (97.8; 100 and 61.9 %, respectively). Severe mucositis (grade 3) was observed in 40.5 and 77.8 % of patients treated with accelerated hyperfractionated radiation in the regimens of 1 Gy+1.5 Gy and 1 Gy+2 Gy, respectively compared to 52.7% of patients treated with the standard radiotherapy (p<0.05) Late radiation-induced damage to normal tissues and organs in the radiation field occurred in 8.9; 10.8 and 20.2 %, respectively (p>0.05). Immediate treatment results and survival analysis showed that chemoradiotherapy with accelerated hyperfractionated radiation was superior to standard radiation therapy without increasing the late local toxicity. All patients completed the planned course of treatment, despite the high rate of grade 3 mucositis in the 1 Gy + 2 Gy dose regimen.
