SHORT-TERM OUTCOMES OF CHEMORADIOTHERAPY USING ACCELERATED HYPOFRACTIONATION FOR THE TREATMENT OF CANCER OF THE OROPHARYNGEAL MUCOSA

Abstract

Objectives. The purpose of this study was to assess the tolerance and efficacy of accelerated hypofractionated chemoradiotherapy for oropharyngeal cancer. Material and methods. The study included 54 patients with morphologically confirmed primary stage II–IV oropharyngeal cancer. All the patients received neoadjuvant polychemotherapy with the PF regimen followed by radiation therapy alone. Radiation was delivered in daily 2.4 Gy fractions five days per week to high-risk areas up to a total dose of 62.4 Gy and to low-risk areas up to a total dose of 45.6–48 Gy. Results. A response to neoadjuvant chemotherapy was noted in 75.9 % of cases. Stable disease was seen in 24.1 % of patients. After accelerated hypofractionated radiation therapy, 50 (92.6 %) patients demonstrated tumor response and 4 (7.4 %) demonstrated stable disease. A complete response was achieved in 38 (76.0 %) and partial response was achieved in 12 (24.0 %) patients. The one-year overall survival rate was 83.8 %. Grade III and II oral mucositis was observed in 38 (70.4 %) and 16 (29.6 %) of cases, respectively. Therapy had to be interrupted in 33 (61.1 %) patients. On average, the treatment break lasted 14.2 ± 2.4 days. There was no statistically significant difference in survival rates between the patients treated with or without treatment break (p=0.418). The one-year overall survival rates were 88.9 and 70.0 %, respectively. Conclusion. Evaluation of short-term outcomes and our initial experience with accelerated hypofractionated irradiation at 2.4 Gy per fraction in the treatment of oropharyngeal cancer do not still allow us to draw any firm conclusions on these matters. Further follow-up is needed to make an assessment of long-term treatment outcomes and late toxicities.