Acceleration of hyperfractionated chemoradiation regimen for advanced head and neck cancer

✍ Scribed by Aaron M. Allen; Mohamed Elshaikh; Francis P. Worden; Carol R. Bradford; Theodoros N. Teknos; Douglas B. Chepeha; Christina Tsien; Laura A. Dawson; Susan Urba; Gregory T. Wolf; Daniel Normolle; Avraham Eisbruch

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 166 KB
• Volume: 29
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20495

✦ Synopsis

Abstract

Background.

Our aim was to evaluate the acceleration of a hyperfractionated, concurrent chemoradiation regimen (HxCRT) for advanced head and neck squamous cell carcinoma (HNSCC).

Methods.

Patients with unresectable HNSCC were treated based on a previously published HxCRT regimen: 1.25 Gy twice daily to 70 Gy concurrent with cisplatin 12 mg/m^2^/day and5‐fluorouracil 600 mg/m^2^/day for 5 days, weeks 1, 5. This regimen was accelerated in this series by shortening the treatment from 7 to 6 weeks by omitting the planned mid‐treatment 1‐week break.

Results.

Forty‐six patients with T3‐4/N3 disease were treated. The main acute toxicity was pharyngeal. Median weight change during therapy in patients with and without enteral feeding tubes was −3.8% and −7.9%, respectively (p = .08). Fifteen percent had late grade III pharyngeal toxicity. Local/regional and distant failure rates were 28% and 17%, respectively; 52% are alive without evidence of disease.

Conclusions.

In nonresectable HNSCC, acceleration of the HxCRT regimen is feasible, requiring enteral feeding tubes during therapy in most patients. © 2006 Wiley Periodicals, Inc. Head Neck, 2007