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    Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharyngeal cancer: A multi-centre study

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    Authors
    Price, James M
    West, 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
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    Affiliation
    Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
    Issue Date
    2022
    
    Metadata
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    Abstract
    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 Oncology
    URI
    http://hdl.handle.net/10541/625322
    DOI
    10.1016/j.radonc.2022.05.013
    PubMed ID
    35595173
    Additional Links
    https://dx.doi.org/10.1016/j.radonc.2022.05.013
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radonc.2022.05.013
    Scopus Count
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