@article{3077294,
    title = "Is locally advanced head-neck cancer one more candidate for accelerated hypofractionation?",
    author = "KOUKOURAKIS, I.M. and ZYGOGIANNI, A. and KOULOULIAS, V. and KYRGIAS, G. and PANTELIADOU, M. and NANOS, C. and ABATZOGLOU, I. and KOUKOURAKIS, M.I.",
    journal = "ANTICANCER RESEARCH",
    year = "2021",
    volume = "41",
    number = "1",
    pages = "467-475",
    publisher = "International Institute of Anticancer Research",
    issn = "0250-1291",
    doi = "10.21873/anticanres.14797",
    keywords = "amifostine;  cetuximab;  chlorhexidine;  cisplatin;  codeine phosphate;  docetaxel;  fluorouracil;  mouthwash;  paracetamol;  posaconazole, acute toxicity;  adenocarcinoma;  adult;  advanced cancer;  aged;  analgesia;  anaplastic carcinoma;  Article;  cancer combination chemotherapy;  cancer patient;  cancer radiotherapy;  cancer survival;  chemoradiotherapy;  clinical target volume;  computer assisted tomography;  conformal radiotherapy;  controlled clinical trial;  controlled study;  dysphagia;  female;  follow up;  gross tumor volume;  head and neck cancer;  head and neck squamous cell carcinoma;  human;  hypofractionated accelerated radiotherapy;  hypofractionated radiotherapy;  hypopharynx cancer;  image guided radiotherapy;  induction chemotherapy;  intensity modulated radiation therapy;  larynx cancer;  larynx carcinoma;  larynx edema;  local disease free survival;  local progression free survival;  major clinical study;  male;  mouth cancer;  mouth hygiene;  mucosa inflammation;  multiple cycle treatment;  mycosis;  nasopharynx cancer;  neck cancer;  organs at risk;  oropharynx;  oropharynx cancer;  pharyngitis;  physical examination;  planning target volume;  primary tumor;  priority journal;  progression free survival;  prospective study;  radiation dose fractionation;  radiation injury;  radiation response;  radiotherapy dosage;  sarcoma;  swallowing;  therapy delay;  tooth brushing;  tracheoesophageal fistula;  treatment duration;  volumetric modulated arc therapy;  adverse event;  cancer staging;  head and neck tumor;  intensity modulated radiation therapy;  Kaplan Meier method;  metastasis;  middle aged;  mortality;  multimodality cancer therapy;  pathology;  procedures;  prognosis;  treatment outcome;  very elderly;  young adult, Adult;  Aged;  Aged, 80 and over;  Chemoradiotherapy;  Combined Modality Therapy;  Dose Fractionation, Radiation;  Female;  Head and Neck Neoplasms;  Humans;  Kaplan-Meier Estimate;  Male;  Middle Aged;  Neoplasm Metastasis;  Neoplasm Staging;  Prognosis;  Radiation Dose Hypofractionation;  Radiotherapy Dosage;  Radiotherapy, Intensity-Modulated;  Treatment Outcome;  Young Adult",
    abstract = "Background/Aim: Hypofractionated accelerated radiotherapy (HypoAR) is widely applied for the treatment of early laryngeal cancer. Its role in locally advanced head-neck cancer (LA-HNC) is unexplored. Patients and Methods: We present results of a prospective trial on 124 patients with LAHNC, treated with radio-chemotherapy with three different HypoAR fractionations (3.5 Gy/day × 14-15 fractions, 2.7 Gy/day × 20-21 fractions, and 2.5 Gy/day × 21-22 fractions). Results: Protraction of the overall treatment time due to oropharyngeal mucositis was enforced in 18/57 laryngeal, 6/19 nasopharyngeal, and 15/48 cancer patients with other tumors. Regarding late toxicities, laryngeal edema grade 3 was noted in 5/57 patients with laryngeal cancer, while severe dysphagia was noted in 4/124 and tracheoesophageal fistula formation in 1/124 patients. The complete response rates obtained were 73%, 84%, and 67% in patients with laryngeal, nasopharyngeal, and other tumors, respectively. The 3-year locoregional progression-free survival was 58%, 73%, and 55%, respectively. Conclusion: HypoAR chemoradiotherapy is feasible, with acceptable early and late radiotherapy toxicities, response rates and LPFS. © 2021 International Institute of Anticancer Research. All rights reserved."
}