Accelerated fractionation radiotherapy: an answer to the financial burden of locally advanced head and neck cancer patients in India seeking treatment at centers far away from home
Journal Title: JOURNAL OF BIOLOGICAL ENGINEERING RESEARCH AND REVIEW - Year 2018, Vol 5, Issue 2
Abstract
Radiotherapy with concurrent Chemotherapy is the treatment of choice for locally advanced head & neck cancers as Surgery is often not suitable. Concurrent chemoradiation is associated with higher toxicity and cost. This work was done to study the feasibility and effectiveness of accelerated fractionation radiotherapy in locally advanced head & neck cancers. Total 39 patients of head & neck cancers with Stage: T4, N0 to N2, M0 included. Site wise distribution: oral cavity 21, oropharynx 16, larynx 1 and pyriform fossa 1. External beam radiotherapy given on telecobalt unit with two lateral parallel opposed and lower anterior neck portals. A tumor dose (TD) of 60Gy / 24 #/ 4 weeks was delivered. Spinal cord spared after 40 Gy/16 #. Overall response rate was 100%, 70% and 77% at 0, 3 and 6 months respectively. At 3months, CR in oral cavity 82%, in oropharynx 33%, in N0 patients 100%, in node positive patients 30%. In 85% cases treatment completed within 5 weeks. Grade 3 acute skin reactions in 96% and grade 3 mucosal reactions in 24% cases. The accelerated fractionated radiotherapy (AFRT-4W) in 4 weeks is feasible in locally advanced HNSCC. The overall response seems to be quite good. AFRT-4W seemed to be most effective in oral cavity and N0 cases. Acute toxicities were severe but manageable conservatively. As total treatment time was reduced by 2 weeks (compared to conventional fractionation) duration of hospital stay and expenditure reduced.
Authors and Affiliations
D. K. Mondal, L. M. Aggarwal, U. P. Shahi
Keywords
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