Effectiveness and toxicity of hypofractionated high-dose intensity-modulated radiotherapy versus 2- and 3-dimensional radiotherapy in incurable head and neck cancer

Head Neck. 2016 Apr:38 Suppl 1:E1264-70. doi: 10.1002/hed.24203. Epub 2015 Sep 2.

Abstract

Background: This retrospective study evaluates efficacy and tolerability of high-dose hypofractionated radiotherapy (RT) in patients with head and neck cancer.

Methods: All patients with head and neck cancer treated between September 2003 and September 2013 with 12 × 4 Gy RT were included. Two and 3D-RT or intensity-modulated radiotherapy (IMRT) were used. Overall survival (OS), tumor response, and palliative effect were evaluated.

Results: Palliative effect occurred in 63% of 81 included patients, lasted a median of 4.6 months, and was correlated with tumor response (p = .006). Median OS was 7.2 months. Confluent mucositis occurred more often in patients treated with 2D/3D-RT than IMRT (26% vs 44%; p = .04) and lasted for a median of 2 weeks.

Conclusion: High-dose hypofractionated RT resulted in meaningful palliation in 63%, lasting for almost 5 months. IMRT should be the technique of choice, as it results in less high-grade toxicity. The 12 × 4 schedule should be opted for patients with reasonable functional capacities and a life expectancy of >6 months. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1264-E1270, 2016.

Keywords: fractionation; head and neck cancer; intensity-modulated radiotherapy (IMRT); palliation; radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Mucositis / complications
  • Radiation Dose Hypofractionation*
  • Radiotherapy, Intensity-Modulated*
  • Retrospective Studies