Gökhan ÖZYİĞİT, Branislav JEREMIC, Pavol DUBINSKY, Marta JEREMIC

Impacts of Radiotherapy Fractionation on Outcome in Squamous Cell Head and Neck Cancer (SQC HNC)

Although conventional fractionated (CF) radiotherapy (RT) became the most common non-surgicalapproach delivering 66-70 Gy in 33-35 daily fractions (fx) in 6.5-7 weeks several decades ago due to agood local control (LC) with low normal tissue complication rates, recent decades also brought alteredfractionated RT regimens based on better understanding of radiobiology. Of these, split course RT islargely abandoned due to inferior results caused by the treatment gap, which led to inferior local controlrates and consequently survival. Hyperfractionated (Hfx) RT and various forms of accelerated (Acc) RThad consistently shown improvement in the treatment outcome, given either alone or with concurrentchemotherapy (CHT). Hfx RT was most consistently superior to CF and frequently to Acc RT, whilemoderate Acc RT also holds promise to be used more often in daily clinical practice. The use of HfxRT may face the challenge of applicability in busy radiotherapy departments around the world despiteunequivocally having been proven as superior regarding both local/regional tumor control and overallsurvival. With concurrent CHT, although results favor it, risks of accompanying toxicity rise and shouldbe considered when planning such intensified treatment approach.

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