SPLIT-COURSE ACCELERATED HYPERFRACTIONATED RADIOTHERAPY IN HEAD AND NECK CARCINOMA- AN EXPERIENCE IN TERMS OF LOCAL TUMOUR CONTROL AND TOXICITY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 42
Abstract
BACKGROUND Radiotherapy alone was long the standard nonsurgical therapy for locally advanced disease. A recent meta-analysis of randomised trial testing modified fractionation schemes against conventional once-daily fractionation demonstrated that hyperfractionation was the most effective strategy, leading to an 8% absolute improvement in 5-year survival. Split-course technique has been used in head and neck cancer patients as an alternative to conventional fractionation. Current evidence shows that split-course radiotherapy is radiobiologically sound and produces similar results as conventional radiotherapy with less number of fractions and increased patient compliance. In our study, we would like to present the results of split-course radiotherapy in advanced head and neck cancer. Aims and Objectives- To evaluate split-course accelerated hyperfractionated radiotherapy in aspects of Local Tumour Control and early and Late Radiation Toxicity. MATERIALS AND METHODS 50 patients with squamous cell carcinoma of oral cavity, anterior 2/3rd of tongue, Alveolus, Lip in stage III and IV have been treated in SGPT Cancer Hospital, MGM Medical College, Indore from Feb. 2013 to Feb. 2014. There were 18 patients with stage III and 32 patients with stage IV, all the patients were treated by radiation therapy alone. Using the technique of opposed parallel fields and split-course accelerated hyper-fractionation with similar dose per fraction and reduced boost volume during the second part of treatment schedule. The total dose was 64 Gy. The median follow-up period was 16 months. RESULTS Grade III and IV acute toxicity was observed in 32% and 16% of the patients. At one and half years, complete response and partial response were 56% and 36% respectively and 8% patients with no response. CONCLUSION Patients unable to tolerate continuous-course definite (Chemo) Radiotherapy, split-course accelerated hyperfractionated radiotherapy is safe, well tolerated and effective method of achieving durable locoregional disease control.
Authors and Affiliations
Ramesh Arya, Vinay Shivhare, Preeti Jain, Allwin George, Love Goyal, Minal Iyer, Vaibhav Saini
Keywords
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- EP ID EP214058
- DOI 10.14260/Jemds/2017/713
- Views 70
- Downloads 0
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