A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma
Background: Accelerated fractionation radiotherapy has radiobiological advantage of preventing accelerated tumor repopulation and logistic advantage of treating more patients than conventionally fractionated radiotherapy because of its relatively shorter treatment duration. Aims and Objectives: I...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2022-12-01
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| Series: | Asian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/47437 |
| _version_ | 1828097505334657024 |
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| author | Chayan Roy Linkon Biswas Arabinda Roy Shyam Sharma Firdoushi Khatun Srikrishna Mandal |
| author_facet | Chayan Roy Linkon Biswas Arabinda Roy Shyam Sharma Firdoushi Khatun Srikrishna Mandal |
| author_sort | Chayan Roy |
| collection | DOAJ |
| description | Background: Accelerated fractionation radiotherapy has radiobiological advantage of preventing accelerated tumor repopulation and logistic advantage of treating more patients than conventionally fractionated radiotherapy because of its relatively shorter treatment duration.
Aims and Objectives: In this study, we compared accelerated fractionation with conventionally fractionated radiotherapy in terms of tumor response and acute toxicities for the treatment of locally advanced head-and-neck carcinomas.
Materials and Methods: Patients with Stage III and IVA carcinoma of head-and-neck region were randomized into two groups. The study group patients received accelerated radiotherapy to a total dose of 66Gy in 33 fractions, 2Gy/fraction, 6 fractions/week over a time period of 5.5 weeks. Control group received conventionally fractionated radiotherapy to same total dose and fraction size but 5 fractions/week, over a time period of 6.5 weeks. Both groups received concurrent weekly Cisplatin. All patients were followed up weekly for treatment related acute toxicity during the treatment and then at every month for 6 months after completion of treatment.
Results: About 26.6% patients of study arm achieved complete response in comparison to 25.6% of control arm, but the difference was not statistically significant (P=0.957). Although statistically not significant, higher grade of skin toxicity (60%vs.35%, P=0.179) and xerostomia (46% vs. 29%, P=0.155) was also numerically higher in accelerated fractionation.
Conclusion: For locally advanced head-and-neck carcinoma, accelerated fractionation radiotherapy with concurrent chemotherapy can be considered as an acceptable and effective alternative of conventionally fractionated concurrent chemoradiotherapy in terms of treatment response and acute toxicity profile. |
| first_indexed | 2024-04-11T07:47:27Z |
| format | Article |
| id | doaj.art-b0c53abe5af14d1a9ad54eeb8130d33a |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-04-11T07:47:27Z |
| publishDate | 2022-12-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-b0c53abe5af14d1a9ad54eeb8130d33a2022-12-22T04:36:14ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762022-12-011312281286https://doi.org/10.3126/ajms.v13i12.47437A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinomaChayan Roy 0https://orcid.org/0000-0003-2240-173XLinkon Biswas 1https://orcid.org/0000-0003-0589-769XArabinda Roy 2https://orcid.org/0000-0001-8675-2614Shyam Sharma 3https://orcid.org/0000-0003-4365-6870Firdoushi Khatun 4https://orcid.org/0000-0003-1372-8941Srikrishna Mandal 5https://orcid.org/0000-0001-7268-4868Senior Resident, Department of Radiotherapy, Coochbehar Government Medical College and Hospital, Coochbehar, West Bengal, India Senior Resident, Department of Radiotherapy, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India Senior Resident, Department of Radiotherapy, Raiganj Government Medical College and Hospital, Raiganj, West Bengal, India Assistant Professor, Department of Radiotherapy, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India Junior Resident, Department of Radiotherapy, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India Professor and Head, Department of Radiotherapy, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India Background: Accelerated fractionation radiotherapy has radiobiological advantage of preventing accelerated tumor repopulation and logistic advantage of treating more patients than conventionally fractionated radiotherapy because of its relatively shorter treatment duration. Aims and Objectives: In this study, we compared accelerated fractionation with conventionally fractionated radiotherapy in terms of tumor response and acute toxicities for the treatment of locally advanced head-and-neck carcinomas. Materials and Methods: Patients with Stage III and IVA carcinoma of head-and-neck region were randomized into two groups. The study group patients received accelerated radiotherapy to a total dose of 66Gy in 33 fractions, 2Gy/fraction, 6 fractions/week over a time period of 5.5 weeks. Control group received conventionally fractionated radiotherapy to same total dose and fraction size but 5 fractions/week, over a time period of 6.5 weeks. Both groups received concurrent weekly Cisplatin. All patients were followed up weekly for treatment related acute toxicity during the treatment and then at every month for 6 months after completion of treatment. Results: About 26.6% patients of study arm achieved complete response in comparison to 25.6% of control arm, but the difference was not statistically significant (P=0.957). Although statistically not significant, higher grade of skin toxicity (60%vs.35%, P=0.179) and xerostomia (46% vs. 29%, P=0.155) was also numerically higher in accelerated fractionation. Conclusion: For locally advanced head-and-neck carcinoma, accelerated fractionation radiotherapy with concurrent chemotherapy can be considered as an acceptable and effective alternative of conventionally fractionated concurrent chemoradiotherapy in terms of treatment response and acute toxicity profile.https://www.nepjol.info/index.php/AJMS/article/view/47437head-and-neck carcinoma; accelerated fractionation radiotherapy; conventional fractionation |
| spellingShingle | Chayan Roy Linkon Biswas Arabinda Roy Shyam Sharma Firdoushi Khatun Srikrishna Mandal A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma Asian Journal of Medical Sciences head-and-neck carcinoma; accelerated fractionation radiotherapy; conventional fractionation |
| title | A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma |
| title_full | A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma |
| title_fullStr | A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma |
| title_full_unstemmed | A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma |
| title_short | A comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head-and-neck squamous cell carcinoma |
| title_sort | comparative and prospective study of two different radiation fractionation schedules with concurrent chemotherapy in locally advanced head and neck squamous cell carcinoma |
| topic | head-and-neck carcinoma; accelerated fractionation radiotherapy; conventional fractionation |
| url | https://www.nepjol.info/index.php/AJMS/article/view/47437 |
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