Purpose: A Phase II trial testing a continuous and accelerated regimen of radiotherapy in very advanced head and neck cancers.
Methods and materials: From 1988 to 1990, 47 patients with very advanced and inoperable tumors (38/47 T4) of the oral cavity and the oropharynx were submitted to a continuous and accelerated regimen of hyperfractionated radiation therapy: three daily fractions of 0.9 Gy were delivered 5 days-a-week, up to the 70 Gy total dose, reducing the overall treatment time to 5.5 weeks.
Results: Immediate tolerance was good: only 56% of the patients experienced a Grade 3 mucositis, and the mean weight loss was 2 kg. The 2-year survival rate was 24.6%. The 2-year local control rate was 42.6%, which compares favorably with the 20% local control rate obtained in a historical control group of patients treated with another hyperfractionated regimen between 1978 and 1986. Mid- and long-term tolerance were excellent, no late complication or sequellae were observed which was also quite different from our previous experience.
Conclusion: These results suggest an improvement of the local control and the therapeutic ratio with acceleration of radiotherapy in head and neck cancers.