Comparison of Locoregional Control, Acute Radiation Toxicities and Patient Compliance between Two Different Radiation Fractionation Schedules with Concurrent Chemotherapy in Oropharyngeal Cancer
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction: Irrespectively of the modality of primary treatment for head and neck squamous cell carcinoma, local or locoregional residual or recurrent tumors represent the major cause of treatment failure, emphasizing the role of locoregional control for the patients’ long-term survival. The study compares HFRT-CT and CTRT in stage III and IV carcinoma of oropharynx. Material and Methods: Study arm (HFRT-CT) 1.1 Gy per fraction, two fractions daily with a minimum interfraction interval of 6 hours, five days a week up to a total dose of 72.6 Gy in 66 fractions over 6-6 1/2 weeks and in the control arm (CTRT) 2 Gy per fraction, single fraction a day, five days a week to a total of 66Gy, over 6-6 ½ weeks, both the arms use concurrent chemotherapy with injection cisplatin 40mg/ m2 weekly. Results: At the end of 6th week 28 patients in the HFRT-CT arm and 29 patients in CTRT arm were available for evaluation. In the HFRT-CT arm 24/28(85.7%)patients and in the CTRT arm 21/29(72.4%)patients showed complete response for primary. For nodal disease a complete response of 92.85% and 89.65% were seen in HFRT-CT and CTRT arm respectively. At the 6th week out of the 16 stage III patients in the HFRT-CT arm 13 had complete response(81.3%) and 3 patients had a partial response (18.7%) and out of the 12 stage IV patients 9 patients had a complete response and 3 patients had partial response. Conclusion: Hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced carcinoma, can be delivered with manageable toxicities. A trend towards better outcome for patients having T4 or N3 disease is noted, even though a statistical significance could not be seen.
Authors and Affiliations
Binesh P, Kunhalan Kutty C. K, Prasanth C. C, Jayaraman M B
Keywords
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