Conventional radiotherapy versus concurrent chemoradiotherapy versus accelerated radiotherapy in locoregionally advanced carcinoma of head and neck: Results of a prospective randomized trial

• Published in: Head & neck Vol. 38; no. 2; pp. 202 - 207
• Main Authors: Ghosh-Laskar, Sarbani, Kalyani, Nikhil, Gupta, Tejpal, Budrukkar, Ashwini, Murthy, Vedang, Sengar, Manju, Chaukar, Devendra, Pai, Prathamesh, Chaturvedi, Pankaj, D'Cruz, Anil, Agarwal, Jaiprakash
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.02.2016; Wiley Subscription Services, Inc
• Subjects: accelerated radiotherapy; Adult; Aged; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Cervical cancer; Chemoradiotherapy; chemoradiotherapy (CRT); cisplatin; Cisplatin - therapeutic use; Female; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; head and neck squamous cell carcinoma (HNSCC); Humans; Male; Middle Aged; Mucositis - etiology; Osteoradionecrosis - etiology; Prospective Studies; Radiation therapy; Radiation-Sensitizing Agents - therapeutic use; radiotherapy (RT); Radiotherapy - methods; Radiotherapy Dosage; Severity of Illness Index; Xerostomia - etiology; Young Adult; chemoradiotherapy (CRT); accelerated radiotherapy; cisplatin; head and neck squamous cell carcinoma (HNSCC); radiotherapy (RT)
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.23865

Background The purpose of this study was to report the results of a phase III, 3‐arm, randomized trial comparing conventional radiotherapy (RT) to concurrent chemoradiotherapy (CRT) and accelerated RT in advanced head and neck squamous cell carcinoma (HNSCC). Methods One hundred eighty‐six of 750 planned patients were randomized to receive one of the following treatment plans: RT (66–70 Gy/2 Gy fraction/5 fractions weekly; CRT of weekly cisplatin (30 mg/m2) with the same RT dose; or accelerated RT alone of 66 to 70 Gy/2 Gy fraction/6 fractions weekly were available for analysis. The primary endpoint was locoregional control at 5 years. Results The mean follow‐up was 54 months. Among the 3 arms, CRT showed superior locoregional control (49%; p = .049). RT had lower grade ≥3 mucositis and late toxicity. Conclusion CRT is associated with significantly better locoregional control as compared to RT and accelerated RT with higher but acceptable acute and late toxicities. © 2015 Wiley Periodicals, Inc. Head Neck 38: 202–207, 2016