Rapid hyperfractionated radiotherapy. Clinical results in 178 advanced squamous cell carcinomas of the head and neck
The authors present a series of 178 patients with Stage III or IV squamous cell carcinoma of the head and neck treated by rapid irradiation using multiple and small fractions per day. An initial group of 91 patients (G1) received a total dose of 72 Gy in 80 sessions and 10 days, according to the following split course schedule: J1 to J5, 36 Gy in 40 sessions, eight daily fractions of .9 Gy separated by 2 hours; J6 to J20, rest period; J21 to J25, same as in J1 except that the spinal cord was shielded. This protocol was altered for the following 87 patients (G2) by lessening the total dose to 60 to 66 Gy and the number of fractions to 60. The rest period was lengthened to 4 weeks. All patients but five completed the whole program and the minimal follow-up period was 24 months. At the end of irradiation, 121 patients achieved a total remission, but local recurrences occurred in 56%. Moreover, acute intolerance was considered as severe in 34% of G1 patients, and included extensive mucosal necrosis and bleeding. Although this rate was significantly reduced in G2 patients, late complications were observed in 20 of the 25 survivors, and included trismus, cervical sclerosis, and recurrent laryngeal edema. The crude survival rate is 13% at 2 years. Although this study was not randomized, this particular type of accelerated and hyperfractionated combination of irradiation did not really improve the clinical results in advanced carcinoma of the head and neck. Other schedules and probably other tumors, less extended, should be tested.
- Research Organization:
- Institut Jean Godinot, Reims, France
- OSTI ID:
- 5244699
- Journal Information:
- Cancer (Philadelphia); (United States), Vol. 1
- Country of Publication:
- United States
- Language:
- English
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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
CARCINOMAS
RADIOTHERAPY
HEAD
MUCOUS MEMBRANES
BIOLOGICAL RADIATION EFFECTS
NECK
SIDE EFFECTS
FRACTIONATED IRRADIATION
NECROSIS
PATIENTS
RADIATION DOSES
SURVIVAL TIME
BIOLOGICAL EFFECTS
BODY
BODY AREAS
DISEASES
DOSES
IRRADIATION
MEDICINE
MEMBRANES
NEOPLASMS
NUCLEAR MEDICINE
PATHOLOGICAL CHANGES
RADIATION EFFECTS
RADIOLOGY
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)
560151 - Radiation Effects on Animals- Man