Impact of average weekly dose of radiation during radiotherapy alone or chemoradiotherapy in head and neck cancer

Head Neck. 2011 Nov;33(11):1551-6. doi: 10.1002/hed.21634. Epub 2010 Dec 9.

Abstract

Background: Altered fractionated radiotherapy (RT) has been shown to improve locoregional control (LRC) and overall survival (OS) in squamous cell cancer of the head and neck (SCCHN). We investigated patient outcomes using a new parameter: the average weekly dose (AWD).

Methods: The medical records of 601 patients who received definitive RT for SCCHN were reviewed. AWD was calculated by dividing the total dose in Gray (Gy) by overall treatment time in weeks, and assessed for predictive value.

Results: Various standard RT fractionation schedules were used. An AWD >10.0 Gy was associated with improved LRC at 2 years for patients treated with RT alone (80.9% vs 60.9%; p = .006), but not for those treated with concurrent chemoradiation (75.3% vs 77.3%; p = .77). Nonsignificant increases in late dysphagia were seen with AWD >10.0 Gy.

Conclusion: An AWD of >10 Gy was found to be beneficial for RT alone regimens but not chemoradiotherapy regimens.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Chemoradiotherapy / methods*
  • Cohort Studies
  • Databases, Factual
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Dose-Response Relationship, Radiation
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Treatment Outcome
  • Young Adult