Accelerated Fractionation With Concomitant Boost vs. Conventional Radio-chemotherapy for Definitive Treatment of Locally Advanced Squamous Cell Carcinoma of the Head-and-Neck (SCCHN).
BACKGROUND/AIM
Patients with unresectable head-and-neck cancer (SCCHN) unable to tolerate radiochemotherapy may receive unconventionally fractionated radiotherapy. This retrospective study compared both treatments.


PATIENTS AND METHODS
Eight patients unsuitable for chemotherapy were assigned to accelerated fractionation with concomitant boost (AF-CB, 69.6 Gy/39 fractions) over 5.5 weeks (group A) and 72 patients to cisplatin-based radiochemotherapy (70 Gy/35 fractions) over 7 weeks (group B). Groups were matched (cancer site, gender, age, performance score, T-/N-stage, histologic grade) and compared for loco-regional control (LRC), metastases-free survival (MFS), overall survival (OS) and toxicities.


RESULTS
LRC, MFS, OS and radiation-related toxicities were not significantly different between groups A and B. Improved outcomes were associated with favorable cancer site, better performance score and T3-stage. In group B, toxicity led to reduction/discontinuation of chemotherapy in 38.9% and interruptions of radiotherapy >7 days in 19.3% of patients.


CONCLUSION
AF-CB appeared a reasonable alternative for patients who cannot safely receive radio-chemotherapy for unresectable SCCHN.
['Narvaez|Carlos A|CA|', 'Schild|Steven E|SE|', 'Janssen|Stefan|S|', 'Schroeder|Ursula|U|', 'Bruchhage|Karl L|KL|', 'Hakim|Samer G|SG|', 'Rades|Dirk|D|']
D000368:Aged D059248:Chemoradiotherapy D003131:Combined Modality Therapy D019583:Dose Fractionation, Radiation D005260:Female D005500:Follow-Up Studies D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D060787:Neoplasm Grading D009362:Neoplasm Metastasis D009367:Neoplasm Staging D011379:Prognosis D011879:Radiotherapy Dosage D000077195:Squamous Cell Carcinoma of Head and Neck D016896:Treatment Outcome
accelerated fractionation concomitant boost conventional radio-chemotherapy Locally advanced head-and-neck cancer stage IV disease