A comparison of conventional and accelerated hypofractionated radiotherapy in definitive chemoradiation for locally advanced head and neck carcinoma: a retrospective cohort study
- Author:
Arkaja TRIPATHY
1
;
Sandeep MUZUMDER
;
Nirmala SRIKANTIA
;
Ajay BABU
;
MG John SEBASTIAN
;
Avinash H. UDAYASHANKAR
;
Ganesha Dev VASHISHTA
;
John Michael RAJ
Author Information
- Publication Type:Original Article
- From:Radiation Oncology Journal 2023;41(4):248-257
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The study evaluates accelerated hypofractionated radiotherapy (AHRT) compared to conventional fractionation radiotherapy (CFRT) in patients with locally advanced head and neck cancer (LAHNC) receiving definitive chemoradiation therapy.
Materials and Methods:The study includes a retrospective cohort analysis of 120 patients. CFRT arm (n = 65) received 2 Gy per fraction to a dose of 70 Gy over 7 weeks in a three-volume approach, whereas the AHRT arm (n = 55) received 2.2 Gy per fraction to a dose of 66 Gy in 6 weeks with a two-volume approach. The primary outcome was overall survival (OS).
Results:With a median follow-up of 18.9 months, 23 patients died in the AHRT arm, and 45 deaths in the CFRT arm. The median OS was 23.4 and 37.63 months in the CFRT and AHRT arms, respectively (hazard ratio [HR] = 0.709; 95% confidence interval [CI], 0.425–1.18; p = 0.189). The median time to loco-regional control was 33.3 months in the CFRT arm and was not reached in the patient group receiving AHRT (HR = 0.558; 95% CI, 0.30–1.03; p = 0.065). The median progression-free survival was 15.9 months in the CFRT arm and 26.9 months in the AFRT arm (HR = 0.801; 95% CI, 0.49–1.28; p = 0.357). Out of 11 acute toxic deaths, eight were in the CFRT arm.
Conclusion:The study showed a trend towards benefit in terms of locoregional control in the AHRT arm and similar OS. A longer follow-up of patients receiving AHRT is required to assess the benefit.
