Enhanced regeneration response of laryngeal and hypopharyngeal mucosa with accelerated hyperfractionated radiation therapy for glottic cancers

The course and severity of acute mucosal reactions in 22 patients with previously untreated T1-2N0 glottic cancers were compared between two treatment schedules with different dose intensities: accelerated hyperfractionated radiation therapy (AHF) and standard conventional fractionation radiation therapy (CF). AHF consisted of a twice-daily fractionation of 1.5 Gy 10 times weekly to a total dose of 66 Gy given in 30-40 (median, 33) days. For CF, the fractionation was 2 Gy five times weekly for a total dose of 66 Gy in 45-51 (median, 49) days. Both treatment schedules were well tolerated and no treatment interruptions were necessary. The mucosal reaction reached a peak score clearly earlier with AHF than CF and already demonstrated improvement in the final treatment week. In contrast, the reaction persisted with CF. It is suggested that damaged mucosal tissues with AHF can be effectively compensated by enhanced regeneration response due to an adequately high dose intensity, suggesting a possible tolerability advantage for AHF. (author)