Hyperfractionated accelerated radiotherapy in locally advanced head and neck cancers

Purpose: Head and neck cancers are rapidly proliferating and relatively radiosensitive tumors. The increase in the number of daily fractions and the decrease in total treatment time give promising results in clinical practice. Patients and Methods: 20 patients diagnosed with head and neck cancer between August 2000 and July 2001 participated in this study. Median age was 63 years (range: 42-78). The tumors were mainly located in the larynx (40%), and in the hypopharynx (25%). Daily doses of 1.5 Gy thrice a day in 6-h intervals were given on each of 12 consecutive days with the exception of weekends. Results: Median follow-up was 22 months (range: 1-62). The overall response rate was 90%, and grade IIII early toxicity was 24%. No grade IV early toxicity was observed. Grade IV late toxicity was observed just in 1 case. 5-year rates for locoregional recurrence, distant metastasis, progression-free survival, and overall survival were 45, 20, 20, and 25%, respectively. Conclusion: Our schedule was acceptable regarding the toxicity. However, the high incidence of locoregional failures urges us to modify the treatment modality.