Sanghera, P., Arnfield, John, McConkey, Christopher C. and Hartley, A.. (2008) Gap compensation during accelerated hypofractionated radiotherapy in head and neck cancer. Journal of Radiotherapy in Practice, Vol.7 (No.1). pp. 31-38. ISSN 1460-3969

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Abstract

Introduction: In squamous-cell carcinoma (SCC) of the head and neck, unplanned gaps risk prolongation of the overall treatment time (OTT) and reduction in tumour control. This audit determines whether further acceleration can safely be employed to compensate for missed treatments during accelerated hypofractionated radiotherapy. Methods: Patients receiving accelerated hypofractionated radiotherapy for SCC of the head and neck were prospectively audited. Outcome measures were OTT, degree of compensation and acute toxicity determined by incidence of grade 3 mucositis, prolonged grade 3 mucositis, grade 3 dysphagia and pain. Results: In the 87 patients identified, the dose administered was 55 Gy in 20 fractions (81 patients), 50 Gy in 20 fractions (1 patient) and 50 Gy in 16 fractions (5 patients). Of those patients receiving 20 fractions, 94% completed within 28 days. Grade 3 mucositis was seen in 56 patients (64%). Compensating for unplanned gaps did not result in any significant increase in toxicity. Administering 6 fractions/week, as compensation, was associated with a lower pain score (p = 0.003) as was receiving 2 fractions on the same day (p = 0.0004). Conclusions: Accelerated hypofractionation is tolerable with most patients completing treatment within the planned OTT. When unplanned gaps occur, then compensation by further acceleration is possible.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RF Otorhinolaryngology R Medicine > RM Therapeutics. Pharmacology
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Squamous cell carcinoma, Neck -- Cancer -- Treatment, Head -- Cancer -- Treatment, Radiotherapy -- Research
Journal or Publication Title:	Journal of Radiotherapy in Practice
Publisher:	Cambridge University Press
ISSN:	1460-3969
Date:	2008
Volume:	Vol.7
Number:	No.1
Page Range:	pp. 31-38
Identification Number:	10.1017/S1460396907006231
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/36997

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