A Prospective Comparative Study of Concurrent Chemoradiation with Accelerated Fractionated Radiotherapy versus Concurrent Chemoradiation with Conventional Fractionation in Locally Advanced Squamous Cell Carcinoma of Head and Neck

ABSTRACT

Introduction: Concurrent chemo-radiation is the standard ofcare for locally advanced head and neck carcinoma. Duringlater part of radiation treatment schedule, there is acceleratedrepopulation of surviving tumour cells. So the treatment shouldbe completed as early as possible. Study aimed to comparethe loco-regional control rates between the acceleratedfractionated and conventional fractionated radiotherapy andto compare the rate of acute and late toxicities between thetwo arms.Material and Methods: Thirty patients with locally advancedhead and neck cancer in the study arm (ARM-A) received sixfractions of radiotherapy per week and thirty-two patients in thecontrol arm (ARM-B) received five fractions of radiotherapyper week. Total radiation dose was same in both arms. Inj.Cisplatin at a dose of 100mg/m2 was given to the patients ofboth the arms every three weeks as a radiosensitizer agent.Results: Complete response rate (19/30 vs 14/32) rate thoughhigher in the study arm, was not statistically significant.Similarly overall response rate (25/30 vs 21/32) was notstatistically significant (P value – 0.15). Among acutetoxicities only dysphagia was significantly higher in the studyarm (P value-0.024). Late toxicities were similar in both thearms.Conclusion: So accelerated fractionation radiotherapy canbe used for treating locally advanced head and neck cancerpatients to improve loco-regional control rate with acceptabletoxicities.