Title: Mucosal And Skin Reactions In Altered Fractionation Radiotherapy In Locally Advanced Oropharyngeal Carcinoma
Authors: Dr Murali. P, Dr Shankar Lal Jakhar, Dr Ramesh Purohit, Dr Rajesh Kumar, Dr Ajay Sharma
DOI: http://dx.doi.org/10.18535/jmscr/v4i5.46
INTRODUCTION: Mucositis and skin reactions are the most commonly encountered acute toxicities in head and neck irradiation. This is significantly higher in altered fractionation regimens. This study highlights the reactions in two different altered fractionation schedules of radiotherapy. AIM: to study the acute mucosal and skin reactions in altered fractionation radiotherapy in locally advanced oro-pharyngeal carcinoma. RESULTS: Among the ARM A and ARM B TNM-stage group at presentation was stage III: 40% and 52% and stage IV: 60 and 48 respectively. Grade III mucositis was encountered in 60% of patients in arm A compared to 32% in arm B (P=<0.01). Grade III skin reactions was seen more in arm A than arm B (52% Vs 24% ) (P=<0.01). CONCLUSION: In altered fractionation radiotherapy, it was found that early boosting has an edge over the late boosting in terms of manageable acute toxicities and better compliance. 1. National Cancer Registry Programme: Consolidated Report of Hospital Based Registries, 1994-1998. 2. Overgaard J, Sand Hansden H, Sapru W et al. Conventional radiotherapy as the primary treatment of squamous cell carcinoma of the head and neck. A randomized multicenter study of 5 versus 6 fractions per week—preliminary report from the DAHANCA 6 and 7 trial. Radiother Oncol 1996;40:S31 . 3. Sasaki T, Sato Y, Sakka M. Cell population kinetics of human solid tumors: a statistical analysis in various histological types. Gann. 1980;71(4):520-9. 4. Thames HD, Jr., Peters LJ, Withers HR, Fletcher GH. Accelerated fractionation vs hyperfractionation: rationales for several treatments per day. Int J Radiat Oncol Biol Phys. 1983;9(2):127-38. 5. Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen AB, Razavi D, Maher EJ, et al. Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol. 1994;33(8):879-85. 6. Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, et al. CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol. 2003;13(3):176-81. 7. Valentina Krstevska and Simonida Crvenkova Altered and Conventional Fractionated Radiotherapy in Locoregional Control and Survival of Patients with Squamous Cell Carcinoma of the Larynx, Oropharynx, and Hypopharynx. Croat Med J. 2006; 47(1): 42–52.Abstract
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