Title: Prospective Study to Compare Conventional Radiotherapy with Hypofractionated Radiotherapy in Locally Advanced Carcinoma of Oral Cavity
Authors; Sanjay Kumar Verma, S.N.Prasad, M.W.Raza
DOI: https://dx.doi.org/10.18535/jmscr/v8i2.135
Abstract
Background: India accounts for higher incidence of oral and oropharyngeal cancer. For early stage chemoradiation or surgery are equally effective. For advanced stage chemoradiotherapy is the treatment of choice. Conventional radiotherapy requires 2Gy per fraction, with 5 fraction per week. Accelarated repopulation sets in 4th weeks of conventional radiotherapy. To overcome this effect hypofractionated radiotherapy may be useful. This study was designed to compare conventional radiotherapy with hypofractionated radiotherapy
Materials and Methods: Total 56 patients (28 patients in each arm)were selected from the cross section of patients registered at tertiary care hospital with histologically proven squamous cell carcinoma of oral cavity from Oct 2017 to July 2019.Data obtained from study was compared to find out differences in term of response, acute and chronic treatment realated toxicity
Results: 39.14% patients(9) in arm A and 36%(9) in arm B had complete response,56;52%(13) in arm A and 48%(12)had partial response in arm B ,4.34%(1) in arm A and 16%(4) in arm B were lost to follow up
Conclusions: Hypofractionated radiotherapy has a comparable response to conventional radiotherapy with slight more acute and late but manageable treatment related toxicity with significantly reduced (3wks) treatment time.
References
- GLOBOCAN 2018, New Global Cancer Data:
- Krstevska V. Radiotherapy and chemotherapy in locally advanced head and neck squamous cell carcinoma. J BUON. 2009;14:361-73.
- Fu KK. Biological basis for the interaction of chemotherapeutic agents and radiation therapy. Cancer. 55:2123.1985.
- Maciejewski B, Preuss-Bayer G, Trott KR.The influence of the number of fractions and overall treatment time on local control and late complication rate in squamous cell carcinoma of the larynx. Int J Radiat Oncol Biol Phys. 1983;9:321-328.
- Withers, H.R., Taylor, J.M., Maciejewski, B. The hazard of accelerated tumor clonogen repopulation during radiotherapy ActaOncol. 1988;27:131–146.
- Withers H, Taylor J, Maciejewski B: The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 27:131-146, 1988.
- Withers H, Peters L, Taylor J, et al: Local control of carcinoma of the tonsil by radiation therapy: An analysis of patterns of fractionation in nine institutions. Int J Radiat Oncol Biol Phys 33:549-562, 1995.
- Sanghera P, McConkey C, Ho KF, Glaholm J, Hartley A. Hypofractionated accelerated radiotherapy with concurrent chemotherapy for locally advanced squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 2007;67:1342-51.
- Somnath Roy, Chandrani Mallik, Suman Ghorai1, Avijit Hazra, Anup Majumdar Hypofractionated versus conventional radiotherapy with or without chemotherapy in head and neck cancer: A comparative study. Clin Cancer Investig J 2015; 4 : 140-6
- Overgaard J, Hansen HS, Specht L, et al. Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: DAHANCA6&7 randomised control trial. Lancet 2003;362:933–940
- Bourhis J, Overgaard J, Audry H, Ang KK, Saunders M, Bernier J, et al. Hyperfractionated or accelerated radiotherapy in head and neck cancer: A meta-analysis. Lancet 2006;368:843-54.
- Castellsague X, Alemany L, Quer M, Halec G, Quiros B, Tous S, et al. (2016) HPV Involvement in Head and Neck Cancers: Comprehensive Assessment of Biomarkers in 3680 Patients. J Natl Cancer Inst, 108(6).