Accelerated radiation therapy helps reduce amount of chemotherapy in advanced head and neck cancer patients

Using an accelerated, shorter course of radiation therapy for patients with advanced head and neck cancer allows doctors to reduce the amount of chemotherapy, thus reducing toxicity, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM.

Between July 2002 and May 2005, this multi-institutional randomized phase III trial analyzed 721 patients with stage III-IV carcinoma of the oral cavity, oropharynx, hypopharynx or larynx, with 360 receiving accelerated radiation and 361 receiving standard radiation with two and three cycles of cisplatin, respectively.

After a median follow up of 4.8 years, the overall survival of accelerated radiation patients versus standard radiation patients was 59 percent and 56 percent respectively. Disease-free survival rates were 45 percent and 44 percent respectively and local-regional failure and metastasis rates were also very similar at 31 and 28 percent and 18 and 22 percent, respectively.

"Accelerated fractionation concurrent with two doses of high dose cisplatinum has the potential to reduce toxicity related to the chemotherapy regimen by not exposing patients to a third cycle," said, Phuc Felix Nguyen-Tan, M.D., presenter of the study for the RTOG and assistant professor of radiation oncology at CHUM Notre-Dame in Montreal, Canada.

The abstract, "A Phase III Trial to Test Accelerated versus Standard Fractionation in Combination with Concurrent Cisplatin for Head and Neck Carcinomas (RTOG 0129): Report of Efficacy and Toxicity," will be presented in the plenary session on Friday, February 26, 2010.