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High fractional dose radiation theraphy of stage III and IV carcinoma of the head and neck
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HIGH FRACTIONAL DOSE RADIATION THERAPY OF STAGE III AND IV CARCINOMA OF THE HEAD AND NECK
Moody D. Wharam, M.D?l, D.J. Lee, M.D.', Haskins Kashima, M.D.* and Stanley E. Order, M.g'
*Presenting Author 'Johns Hopkins Hospital, Division of Radiation Oncology 2Johns Hopkins Hospital, Department of Otolaryngology +Member, American Radium Society
High fractional dose (4Or3 rads/day) radiation therapy of advanced head and neck carcinoma offers the advantage of better local control and reduced overall treatment time compared to conventional fractionation, while not exceeding normal tissue tolerance. Twenty Stage III and IV patients were treated with a total dose of 4400 to 5200 rads in 11 to 13 fractions over 15 to 18 days. Eleven patients remain disease free from 1 to 24 months. Four patients died from intercurrent disease without evidence of tumor 5 to 14 months after therapy. There were 5 local failures. Significant reduction of primary tumors and metastatic adenopathy occurred in 80% of patients during therapy. Marked acute toxicity was limited to patients requiring inclusion of the entire oral cavity and oropharynx in the portal. There have been no major long term complications. Preliminary data on the acute toxicity and early results of a pilot study combining the hypoxic cell sensitizer metronidazole, with high fractional dose radiation therapy will also be presented.
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HIGH FRACTIONAL DOSE RADIATION THERAPY OF STAGE III AND IV CARCINOMA OF THE HEAD AND NECK
Moody D. Wharam, M.D?l, D.J. Lee, M.D.', Haskins Kashima, M.D.* and Stanley E. Order, M.g'
*Presenting Author 'Johns Hopkins Hospital, Division of Radiation Oncology 2Johns Hopkins Hospital, Department of Otolaryngology +Member, American Radium Society
High fractional dose (4Or3 rads/day) radiation therapy of advanced head and neck carcinoma offers the advantage of better local control and reduced overall treatment time compared to conventional fractionation, while not exceeding normal tissue tolerance. Twenty Stage III and IV patients were treated with a total dose of 4400 to 5200 rads in 11 to 13 fractions over 15 to 18 days. Eleven patients remain disease free from 1 to 24 months. Four patients died from intercurrent disease without evidence of tumor 5 to 14 months after therapy. There were 5 local failures. Significant reduction of primary tumors and metastatic adenopathy occurred in 80% of patients during therapy. Marked acute toxicity was limited to patients requiring inclusion of the entire oral cavity and oropharynx in the portal. There have been no major long term complications. Preliminary data on the acute toxicity and early results of a pilot study combining the hypoxic cell sensitizer metronidazole, with high fractional dose radiation therapy will also be presented.
92