EARLY AND LONG-TERM RESULTS OF AN ORIGINAL ACCELERATED RADIATION-THERAPY SCHEDULE IN HEAD AND NECK-CARCINOMA

From November 1985 until October 1988, 39 patients with head and neck carcinoma (6 patients stage I-II and 33 stage III-IV) were treated wit h an accelerated radiotherapy schedule designed to deliver 69.6 Gy ove r a period of 5 weeks. Treatment was started with 20 Gy in 10 daily fr actions to sites of initial macroscopic involvement, followed by bi-fr actionated radiotherapy (2 x 1.6 Gy/day) to a larger head and neck vol ume. Twenty patients received neo-adjuvant chemotherapy. A homolateral radical neck dissection was performed in 2 patients. Twenty-six patie nts (66.6%) presented with acute grade 3 complications and 5 patients (13%) with grade 4 complications. Thirteen patients (33.3%) were hospi talized for supportive care. None of the patients who were evaluated o n a long-term basis developed grade 3 or 4 late complications. The 5-y ear loco-regional control and overall survival rates were 62.4% and 33 .6% respectively. Although acute toxicity is higher than in monofracti onated schedules, it is manageable, and can be considered acceptable i n the light of the apparently good loco-regional control thus obtained . This schedule is one of several accelerated radiotherapy programs wh ich might merit study in prospective trials.