CONTINIOUS HYPERFRACTIONATED ACCLERATED RADIATION THERAPY IN HEAD AND NECK CANCERS - A PILOT STUDY

Abstract

Objectives: To assess the acute radiation reactions and immediate locoregional response of accelerated hyperfractionation radiotherapy in head and neck cancers.

Methods: A prospective study of 20 patients with squamous cell carcinoma of oropharynx, hypopharynx and nasopharynx with stage II – IV received continuous accelerated hyperfractionated radiotherapy (CHART) to a total dose of 54 Gy/36 fractions, dose per fraction of 1.5GY/fraction, 3 fractions /day given at 4-6 hours interval, 6 days / week with overall treatment time of 12 days.

Results: Patients were assessed as per UICC guidelines. 6 patients developed Grade 6 mucositis, 10 patients developed Gr 5 mucositis and remaining 4 patients developed only Gr 3-4 mucositis. All cases of Grade 5 and 6 mucositis resolved in 4 weeks. Majority of patients developed only erythema and patchy dry desquamation of the skin. 12 patients (60%) achieved complete response and 7 patients (35%) achieved partial response at 4-6 weeks after completion of therapy. Median follow up was 8 months.

Conclusion: CHART achieves good locoregional response in stages III and IV of head and neck cancer. The acute mucosal reactions were within acceptable limits. The compliance to the treatment was good.