CONTINIOUS HYPERFRACTIONATED ACCLERATED RADIATION THERAPY IN HEAD AND NECK CANCERS - A PILOT STUDY

Abstract

Objectives: To assess the acute radiation reactions and immediate locoregional response of accelerated hyperfractionation radiotherapy in head and neck cancers. Methods: A prospective study of 20 patients with squamous cell carcinoma of oropharynx, hypopharynx and nasopharynx with stage II – IV received continuous accelerated hyperfractionated radiotherapy (CHART) to a total dose of 54 Gy/36 fractions, dose per fraction of 1.5GY/fraction, 3 fractions /day given at 4-6 hours interval, 6 days / week with overall treatment time of 12 days. Results: Patients were assessed as per UICC guidelines. 6 patients developed Grade 6 mucositis, 10 patients developed Gr 5 mucositis and remaining 4 patients developed only Gr 3-4 mucositis. All cases of Grade 5 and 6 mucositis resolved in 4 weeks. Majority of patients developed only erythema and patchy dry desquamation of the skin. 12 patients (60%) achieved complete response and 7 patients (35%) achieved partial response at 4-6 weeks after completion of therapy. Median follow up was 8 months. Conclusion: CHART achieves good locoregional response in stages III and IV of head and neck cancer. The acute mucosal reactions were within acceptable limits. The compliance to the treatment was good.

Keywords

• CHART
• accelerated hyperfractionation
• acute toxicities
• head and neck cancers