The concomitant boost in accelerated radiotherapy for advanced laryngeal cancer should start in week 3

Abstract

Purpose/Objective: For advanced head and neck cancer accelerated fractionation results in increased local control rates compared to conventional radiotherapy. Accelerated repopulation of tumor cells is seen after the start of radiotherapy. Increase of the daily radiation dose is necessary to counteract for this accelerated repopulation. However, it is unclear at what moment this acceleration starts, a lag period of two to four weeks after the start of radiotherapy is reported. In a prospective study in advanced laryngeal cancer we compared local control rates for two fractionation schedules, starting acceleration in week 3 or week 4.