Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharyngeal cancer: A multi-centre study
Authors
Price, James MWest, Catharine M L
Dixon, L. M.
Iyizoba-Ebozue, Z.
Garcez, Kate
Lee, Lip W
McPartlin, Andrew J
Slevin, F.
Sykes, Andrew J
Prestwich, R. J. D.
Thomson, David J
Affiliation
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UKIssue Date
2022
Metadata
Show full item recordAbstract
Background and purpose: There is renewed interest in hypofractionated radiotherapy, but limited data and a lack of consensus to support use for head and neck cancer. In this multicentre analysis we compared outcomes for patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with conventional and accelerated, mildly hypofractionated radiotherapy without chemotherapy. Materials and methods: A multi-centre, observational study of consecutive OPSCCs treated between 2015 and 2018. Patients underwent curative-intent radiotherapy (oropharyngeal and bilateral neck) using conventionally fractionated (70 Gy in 35 fractions over 7 weeks, n = 97) or accelerated, mildly hypofractionated (65-66 Gy in 30 fractions over 6 weeks, n = 136) radiotherapy without chemotherapy. Locoregional control (LRC) and overall survival (OS) were compared. Patients alive and cancer-free at a minimum of 2 years post-radiotherapy (n = 151, 65%) were sent an MD Anderson Dysphagia Inventory (MDADI) questionnaire to assess swallow function. Results: LRC and OS were similar across schedules (p = 0.78 and 0.95 respectively, log-rank test). Enteral feeding rates during radiotherapy appeared higher in the 7-week group though this did not reach statistical significance (59% vs 48%, p = 0.08). Feeding rates were similar at 1 year post radiotherapy for both groups (10% vs 6%, p = 0.27). 107 patients returned MDADI questionnaires (71%); there were no differences between the 6- and 7-week groups for median global (60.0 vs 60.0, p = 0.99) and composite (65.8 vs 64.2, p = 0.44) MDADI scores. Conclusion: Patients with OPSCC treated with radiotherapy alone have similar swallowing outcomes, LRC and OS following accelerated, mild hypofractionation and standard fractionation schedules, supporting its use as a standard-of-care option for patients unsuitable for concurrent chemotherapy.Citation
Price JM, West CM, Dixon LM, Iyizoba-Ebozue Z, Garcez K, Lee LW, et al. Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharyngeal cancer: A multi-centre study. Vol. 172, Radiotherapy and Oncology. Elsevier BV; 2022. p. 111–7.Journal
Radiotherapy and OncologyDOI
10.1016/j.radonc.2022.05.013PubMed ID
35595173Additional Links
https://dx.doi.org/10.1016/j.radonc.2022.05.013Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.radonc.2022.05.013
Scopus Count
Collections
Related articles
- Long term patient reported swallowing function following chemoradiotherapy for oropharyngeal carcinoma.
- Authors: Dixon L, Ramasamy S, Cardale K, Dyker K, Garcez K, Lee LW, McPartlin A, Murray P, Sen M, Slevin N, Sykes A, Prestwich R, Thomson D
- Issue date: 2018 Sep
- Hypofractionated radiotherapy alone with 2.4 Gy per fraction for head and neck cancer during the COVID-19 pandemic: The Princess Margaret experience and proposal.
- Authors: Huang SH, O'Sullivan B, Su J, Ringash J, Bratman SV, Kim J, Hosni A, Bayley A, Cho J, Giuliani M, Hope A, Spreafico A, Hansen AR, Siu LL, Gilbert R, Irish JC, Goldstein D, de Almeida J, Tong L, Xu W, Waldron J
- Issue date: 2020 Aug 1
- Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial.
- Authors: Widmark A, Gunnlaugsson A, Beckman L, Thellenberg-Karlsson C, Hoyer M, Lagerlund M, Kindblom J, Ginman C, Johansson B, Björnlinger K, Seke M, Agrup M, Fransson P, Tavelin B, Norman D, Zackrisson B, Anderson H, Kjellén E, Franzén L, Nilsson P
- Issue date: 2019 Aug 3
- Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer (HYPO-RT-PC): patient-reported quality-of-life outcomes of a randomised, controlled, non-inferiority, phase 3 trial.
- Authors: Fransson P, Nilsson P, Gunnlaugsson A, Beckman L, Tavelin B, Norman D, Thellenberg-Karlsson C, Hoyer M, Lagerlund M, Kindblom J, Ginman C, Johansson B, Björnlinger K, Seke M, Agrup M, Zackrisson B, Kjellén E, Franzén L, Widmark A
- Issue date: 2021 Feb
- Treatment of oropharyngeal squamous cell carcinoma: Is swallowing quality better after TORS or RT?
- Authors: Campo F, Iocca O, De Virgilio A, Mazzola F, Mercante G, Pichi B, Holsinger FC, Di Maio P, Ramella S, Pellini R
- Issue date: 2023 Jun