Alteredfractionation radiotherapy in head and neck cancer

Radiotherapy for head and neck cancer (HNC) is very useful. If patients with HNC have been cured with radiotherapy, radiotherapy will have been highly beneficial to them. However, the prognosis of advanced HNC is poor. To improve the treatment results of advanced HNC, hyperfractionated radiotherapy and accelerated radiotherapy have been employed. Our institute has treated 117 cases (nasopharynx 5 cases, oropharynx 23 cases, hypopharynx 44 cases, larynx 45 cases) with hyperfractionation (HF) since 1996. Local control rate and overall survival rate of all cases were 67.4% and 65.3% at 5 years, respectively. Compared with conventionally treated cases, our results with HF radiotherapy were better in hypopharyngeal cancers (local control p=0.0005, survival p=0.0023) and oropharyngeal cancers (local control p=0.0003). Recent randomized trials and meta-analyses have demonstrated improved disease-free and/or overall survival rate by altering the schedule. Further trials with chemoradiotherapy in advanced HNC are needed to evaluate the effect and effective regimen. (author)