Is Accelerated Radiation Therapy an Answer where Concurrent Chemoradiation is not Feasible for the Management of Locally Advanced Head and Neck Cancers? A Contribution to the Controvert

Chauhan A , Sehgal SA , Khurana A, Kaur P , Chandrasekaran Aand Takia T

Department of Radiation Oncology, Pt BD Sharma PGIMS, India Department of Radiation Oncology, Ashwin Hospital, India Department of Radiation Oncology, Grecian Super Specialty Hospital, India

^*Correspondance to: Khurana A 

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Abstract:

Background: Head and neck carcinomas are still challenging in the present era. This prospective study has been done to compare standard concurrent chemoradiation with modest accelerated radiotherapy. Material and Methods: Prospective study was done on 150 patients who were, histopathologically proven locally advanced squamous cell carcinoma of the head and neck region presented to PGIMS, Rohtak. They were randomly allotted altered fractionation i.e. 66Gy/33 fractions/5.3 weeks/6 fractions per week (group I) or conventional fractionation radiotherapy plus concomitant chemotherapy i.e. 66Gy/33 fractions/6.3 weeks/5 fractions per week) with weekly injection cisplatin 30 mg/m2 (group II). The end points were tumor response, acute and late toxicities and Overall Survival (OS) at 24 months. Results: All the patients were able to complete the treatment in both the groups. Median follow up was 24 months. Complete response at the end of 24 months was observed in 34 (45.33%) and 36 patients (48%) in group I and group II respectively (p-value =0.744). Toxicity profile didn’t show any statistically significant difference in either group except renal toxicity and weight loss. Slightly higher incidence of acute toxicity was seen in group I patients without any statistical significance. Conclusion: The modest accelerated radiotherapy fractionation with reduced overall time in comparison to conventional chemoradiation is a reasonable option for locally advanced head and neck cancers while avoiding the side effects related to chemotherapy. However large randomized data is required for incorporation into guidelines.

Keywords:

Head and neck cancer; Accelerated radiotherapy; Chemotherapy; Cisplatin; Altered fractionation

Cite the Article:

Chauhan A, Sehgal SA, Khurana A, Kaur P, Chandrasekaran A, Takia T. Is Accelerated Radiation Therapy an Answer where Concurrent Chemoradiation is not Feasible for the Management of Locally Advanced Head and Neck Cancers? A Contribution to the Controvert. Clin Oncol. 2019;4:1664.