Accelerated Radiotherapy Has Potential for Poor Countries
Found more effective than conventional fractionation for squamous-cell carcinoma of the head and neck
WEDNESDAY, April 14 (HealthDay News) -- Accelerated fractionation of radiotherapy is an effective alternative to conventional fractionation for squamous-cell carcinoma of the head and neck (HNSCC) in developing countries, according to research published online April 9 in The Lancet Oncology.
Jens Overgaard, M.D., of Aarhus University Hospital in Denmark, and colleagues randomized 908 patients with HNSCC of the larynx, pharynx and oral cavity from Asia, Europe, the Middle East, Africa, and South America to receive an accelerated regimen of six fractions of radiotherapy per week (458 subjects) or to receive a conventional radiotherapy regimen of five fractions per week (450 subjects), receiving a total dose 66 to 70 Gy in 33 to 35 fractions.
The researchers found that the five-year actuarial rate of locoregional control was higher in the accelerated group than the conventional group (42 versus 30 percent), as was disease-free survival (50 versus 40 percent). Acute morbidity was more common among patients who received the accelerated regimen, with 45 patients in the accelerated group and 22 patients in the conventional group experiencing confluent mucositis. Additionally, 87 patients in the accelerated group and 50 patients in the conventional group experienced severe skin reactions.
"The accelerated regimen was associated with an increased -- but tolerable -- acute morbidity relative to the conventional radiotherapy schedule, with no evidence of increased late radiation complications," the authors write. "The accelerated schedule is therefore more effective than conventional fractionation, and since it does not require additional resources it might be a suitable new international standard of treatment."