Review:

Role of altered fractionation radiotherapy schedules in head and neck squamous cell carcinoma: Rationale, evidence and clinical issues.

 

Pushpa Naga C.H*. MD, DNB, Janaki M.Ga. MD, DNB, Kirthi Koushik A.Sa. MD.

 

*Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

aDepartment of Radiation Oncology, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India

 

*Corresponding author

Dr Pushpa Naga C H

Tata Memorial Hospital, Homi-Bhabha National Institute,

DrErnest Borges Street, Mumbai – 400012

Maharashtra, India

Phone: +912224177168; Fax No: +912224146747

 

 

Abstract 

Purpose: To review and summarize literature concerning the role of various altered fractionation schedules in head and neck squamous cell carcinoma (HNSCC).

Methods and materials: Brief overview of clinical trials investigating role of altered fractionation with conventional fractionation scheme in curative intent radiotherapy of patients with HNSCC are reviewed.

Results: Overall, altered fractionation regimens have demonstrated improved therapeutic outcomes in the curative treatment of HNSCC. On comparison of different schedules, hyper-fractionated radiotherapy has shown more favorable impact with comparable survival advantage to that of concurrent chemo-radiotherapy. Although, the concept of integration concurrent chemotherapy with altered fractionation is promising to improve control, it may be at the expense of additional toxicity. Mild hypo-fractionation may be advantageous in achieving superior results in early glottic tumors.

Conclusions: This summary is a thorough a compilation of large published clinical studies addressing biological rationale, evidence and clinical issues of various altered fractionation schedules and may be useful to facilitate clinician in treatment-decisions making in a clinical context.

 

Key words: Head and neck cancer, Radiotherapy, Altered fractionation.

 

 

 

 

 

 

 

 

 

 

 

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