Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas

Objective: Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. Methods: This monoinstitutio...

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Published inOncology Vol. 76; no. 6; pp. 405 - 412
Main Authors Welz, Hanna, Pöttgen, Christoph, Abu Jawad, Jehad, Wierlemann, Arne, Wittig, Andrea, Stüben, Georg, Budach, Volker, Lehnerdt, Goetz, Jahnke, Klaus, Sack, Horst, Stuschke, Martin
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.06.2009
Subjects
Chemotherapy
Clinical Study
Comparative studies
Head & neck cancer
Oncology
Radiation therapy
Head and neck cancer
Mitomycin C
5-Fluorouracil
Accelerated radiotherapy
Concomitant chemotherapy
Hyperfractionation
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Summary:Objective: Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. Methods: This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70–72 Gy) with curative intent. Results: Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year 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 variate with the fractionation schedule used. Conclusions: In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.
ISSN:0030-2414
1423-0232
DOI:10.1159/000215927