Evaluation of accelerated hyperfractionation in radiotherapy of advanced squamous cell carcinoma of the oral cavity and oropharynx

In a prospective study 66 patients with advanced squamous cell carcinoma of the oral cavity and oropharynx were analysed. They were treated at the Center of Oncology in Cracow between 1987 and 1993. All patients were treated with accelerated hyperfractionated radiotherapy. The patients were irradiated twice - a day, 5 days a week, a minimum interval between fractions was at least 6 hours. Three groups of patients were selected by the treatment option: Group I - 25 patients. Total tumor and first stage lymph nodes dose was 5440 cGy in 34 fractions over 22 days of treatment. Fraction dose was 170 cGy. On the days of irradiation each patient received 10 mg of cisplatin in intravenous infusion 30 minutes prior to the second session. Group II - 15 patients. The radiotherapy was the same as in group I. No cisplatin was given. Group III - 26 patients. Total tumor and first stage lymph nodes dose used was 6120 cGy in 34-36 fractions over 23-24 days of treatment. Fraction dose was 180 cGy in 20 patients and 170 cGy in 6 patients. The actuarial 3-year no evidence of disease survival assessed by Kaplan and Meier method were 25.7%, 33.3% and 22.4% respectively for group I, II and III. These differences were not statistically significant. The actuarial 3-year overall survival rates assessed by Kaplan and Meier method were 30.2%, 40% and 30.8% respectively for groups I, II and III. These differences were also statistically insignificant. (author)