Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas

Publisher： Karger

E-ISSN： 1423-0232|76|6|405-412

ISSN： 0030-2414

Source： Oncology, Vol.76, Iss.6, 2009-05, pp. : 405-412

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Abstract

Objective: Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. Methods: This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70–72 Gy) with curative intent. Results: Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. Conclusions: In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.