Comparison of Toxicities Associated with Concomitant Boost and Conventional Fractionated Radiotherapy Regimen in Oral and Oropharyngeal Cancers

Abstract

Introduction: The prevalence of Head and Neck Cancers (HNC) is very high in the Indian subcontinent. Radiotherapy is an essential modality in the management of HNC. Aim: The aim of the present study was to compare toxicities of two radiotherapy fractionation regimen (conventional fractionation and concomitant boost technique) for the management of HNC. Materials and Methods: A total of 60 patients (n=30 in each arm) were assigned to receive either conventional fractionation or concomitant boost radiotherapy. Toxicities were analysed weekly during the treatment, and one and three month after treatment completion. The radiation therapy oncology group acute radiation morbidity scoring system was used to document the severity. Toxicities assessed were mucositis, skin reactions, dysphagia and xerostomia. Statistical analysis was done by the online Graphpad software using Chi-square test. A value of p<0.05 was considered significant. Results: Overall mean age of the patients was 47.35 years (range 23-70 years). There was a male preponderance in both groups (Group A=73.33%, Group B= 76.6%). Most common primary sub site in Group A was tongue (33.3%) and in Group B was buccal mucosa (50%). On statistical analysis of toxicity comparison during and post treatment completion, no significant difference in toxicity was found between the two arms in terms of mucositis (p=1), skin reactions (p=0.6404), dysphagia (p=0.7906) and xerostomia (p=0.1066). Conclusion: The concomitant boost technique resulted in no statistically significant difference in toxicity as compared to the conventional fractionation with the added advantage of reduced overall treatment time. This may be a favourable schedule for high volume centers.

Keywords

• Fractionation
• Head and neck cancers
• Morbidity
• Radiotherapy