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Hyperfractionated accelerated radiotherapy versus conventional fractionation both combined with chemotherapy in patients with locally advanced head and neck carcinomas
Oncology (Karger), 05/08/09

Welz H et al. - In a study to assess the use of conventionally fractionated radiotherapy (CFRT) vs hyperfractionated accelerated radiotherapy (HART) both in combinations with chemotherapy (CC) for locally advanced head and neck cancer (HNC), it was found that there was no trend towards an improved efficacy of HART in comparison with CFRT.

Methods

This study compares the results of both treatment schedules: 315 pts with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated with radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 pts, CFRT-CC: 112 pts, total dose: 70-72 Gy) with curative intent.

Results

2- and 4-yr survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC), respectively.
Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the yr of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant.
The prognostic value of these pretreatment factors did not vary with the fractionation schedule used.

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