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• W2065699682 abstract "Purpose/Objective: We previously reported two-year results demonstrating the superiority of hyperfractionation and concomitant boost schedules over standard radiotherapy. We now report 5-year outcomes from RTOG 90–03.Materials/Methods: Patients with locally advanced head and neck cancer were randomly assigned to receive radiotherapy delivered with: 1) standard fractionation (SFX) 2) hyperfractionation (HFX) 3) accelerated fractionation with split (AFX-S) or 4) accelerated fractionation with concomitant boost (AFX-C). Of the 1113 patients entered, 1073 patients were analyzable for outcomes. The median follow-up was 1.8 years for all analyzable patients and 5.3 years for patients still alive.Results: Patients treated with HFX and AFX-C regimens had significantly better 5-year local-regional control (p=0.037 and p= 0.042 respectively) than those treated with SFX. They experienced improved disease-free survival with them (p=0.013 and p=0.042 respectively). There was a trend toward improved overall survival in patients treated with hyperfractionation (p=0.063); there was no significant difference in cause-specific survival. There were no significant differences in the incidence of distant metastasis. Toxicity occurring within 180 days from the start of radiation was considered to be acute and beyond that, late. All three altered fractionation arms showed a significantly higher crude incidence of patients with grade 3+ acute side effects when compared to SFX. There was a trend toward an increased crude incidence of grade 3+ late effects with AFX-C compared to SFX (33.3% vs. 25.2%, p=0.066), but the incidences for HFX and AFX-S arm were similar to SFX. (27.4% and 26.8%)Conclusions: Five year results of hyperfractionation and accelerated fractionation with concomitant boost demonstrate superiority over standard fractionation for locally advanced head and neck cancer. Acute effects were increased in altered fractionation schedules and there was a slightly higher incidence of late effects with the concomitant boost schedule. Data will be updated for ASTRO 2005 with a potential 8-year median follow-up for the patients still alive.Tabled 1Five-Year Rates##Kaplan-Meier method; * Rates for LRF and DM are failure rates, not control rates Purpose/Objective: We previously reported two-year results demonstrating the superiority of hyperfractionation and concomitant boost schedules over standard radiotherapy. We now report 5-year outcomes from RTOG 90–03. Materials/Methods: Patients with locally advanced head and neck cancer were randomly assigned to receive radiotherapy delivered with: 1) standard fractionation (SFX) 2) hyperfractionation (HFX) 3) accelerated fractionation with split (AFX-S) or 4) accelerated fractionation with concomitant boost (AFX-C). Of the 1113 patients entered, 1073 patients were analyzable for outcomes. The median follow-up was 1.8 years for all analyzable patients and 5.3 years for patients still alive. Results: Patients treated with HFX and AFX-C regimens had significantly better 5-year local-regional control (p=0.037 and p= 0.042 respectively) than those treated with SFX. They experienced improved disease-free survival with them (p=0.013 and p=0.042 respectively). There was a trend toward improved overall survival in patients treated with hyperfractionation (p=0.063); there was no significant difference in cause-specific survival. There were no significant differences in the incidence of distant metastasis. Toxicity occurring within 180 days from the start of radiation was considered to be acute and beyond that, late. All three altered fractionation arms showed a significantly higher crude incidence of patients with grade 3+ acute side effects when compared to SFX. There was a trend toward an increased crude incidence of grade 3+ late effects with AFX-C compared to SFX (33.3% vs. 25.2%, p=0.066), but the incidences for HFX and AFX-S arm were similar to SFX. (27.4% and 26.8%) Conclusions: Five year results of hyperfractionation and accelerated fractionation with concomitant boost demonstrate superiority over standard fractionation for locally advanced head and neck cancer. Acute effects were increased in altered fractionation schedules and there was a slightly higher incidence of late effects with the concomitant boost schedule. Data will be updated for ASTRO 2005 with a potential 8-year median follow-up for the patients still alive. #Kaplan-Meier method; * Rates for LRF and DM are failure rates, not control rates" @default.
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• W2065699682 date "2005-10-01" @default.
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• W2065699682 title "Long Term Outcomes of RTOG 90–03: A Comparison of Hyperfractionation and Two Variants of Accelerated Fractionation to Standard Fractionation Radiotherapy for Head and Neck Squamous Cell Carcinoma" @default.
• W2065699682 doi "https://doi.org/10.1016/j.ijrobp.2005.07.122" @default.
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