ASTRO Patient Summary: 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
Traditionally, radiation has been administered once a day for 5 days a week. In the late 1980's, some centers had been performing variations of twice-daily treatments to see if this could maximize cell killing. This study was opened to examine the various treatments being used. The study randomly assigned head and neck cancer patients to receive one of four regimens (see article for specific regimens). Initial data had been released in 2000, and this session presented data with an average 8.5 years of follow-up. The study found that "accelerated fractionation with concomitant boost" (AFC) and "hyperfractionation, twice daily", had better local control than the other regimens, meaning fewer recurrences at the site of the original tumor. Despite this advantage, these regimens were found to have more long-term side effects. Specifically, the AFC regimen had higher levels of toxicity occurring more than 4 years after treatment. These patients also had high rates of second cancers, with approximately 25% at 5 years and 40% at 10 years. The reviewer suggested continued long-term data from this study would be helpful, as would continued research into decreasing rates of long-term side effects.