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Ghosh-Laskar S.,Tata Memorial Hospital Center | Kalyani N.,Tata Memorial Hospital Center | Gupta T.,Tata Memorial Hospital Center | Budrukkar A.,Tata Memorial Hospital Center | And 7 more authors.
Head and Neck | Year: 2016

Background The purpose of this study was to report the results of a phase III, 3-arm, randomized trial comparing conventional radiotherapy (RT) to concurrent chemoradiotherapy (CRT) and accelerated RT in advanced head and neck squamous cell carcinoma (HNSCC). Methods One hundred eighty-six of 750 planned patients were randomized to receive one of the following treatment plans: RT (66-70 Gy/2 Gy fraction/5 fractions weekly; CRT of weekly cisplatin (30 mg/m2) with the same RT dose; or accelerated RT alone of 66 to 70 Gy/2 Gy fraction/6 fractions weekly were available for analysis. The primary endpoint was locoregional control at 5 years. Results The mean follow-up was 54 months. Among the 3 arms, CRT showed superior locoregional control (49%; p =.049). RT had lower grade ≥3 mucositis and late toxicity. Conclusion CRT is associated with significantly better locoregional control as compared to RT and accelerated RT with higher but acceptable acute and late toxicities. © 2015 Wiley Periodicals, Inc. Head Neck 38: 202-207,2016


PubMed | The Surgical Center and Tata Memorial Hospital Center
Type: Clinical Trial, Phase III | Journal: Head & neck | Year: 2016

The purpose of this study was to report the results of a phase III, 3-arm, randomized trial comparing conventional radiotherapy (RT) to concurrent chemoradiotherapy (CRT) and accelerated RT in advanced head and neck squamous cell carcinoma (HNSCC).One hundred eighty-six of 750 planned patients were randomized to receive one of the following treatment plans: RT (66-70 Gy/2 Gy fraction/5 fractions weekly; CRT of weekly cisplatin (30 mg/m(2) ) with the same RT dose; or accelerated RT alone of 66 to 70 Gy/2 Gy fraction/6 fractions weekly were available for analysis. The primary endpoint was locoregional control at 5 years.The mean follow-up was 54 months. Among the 3 arms, CRT showed superior locoregional control (49%; p=.049). RT had lower grade 3 mucositis and late toxicity.CRT is associated with significantly better locoregional control as compared to RT and accelerated RT with higher but acceptable acute and late toxicities.


Gupta T.,Tata Memorial Hospital Center | Kannan S.,Tata Memorial Hospital Center | Ghosh-Laskar S.,Tata Memorial Hospital Center | Agarwal J.P.,Tata Memorial Hospital Center
Head and Neck | Year: 2015

Background Treatment intensification by using chemoradiotherapy (CRT) or altered fractionation radiotherapy (RT) improves outcomes in locoregionally advanced head and neck squamous cell carcinoma (HNSCC). Methods Two comprehensive meta-analyses with similar control arms (conventionally fractionated RT) were compared indirectly. Results The hazard ratio (HR) of death with 95% confidence interval (CI) for the overall comparison of altered fractionation RT with concomitant CRT was 1.13 (95% CI, 0.97-1.29; p =.07) suggesting no significant difference between both approaches. Compared to concomitant CRT, the HR for death was 1.01 (95% CI, 0.89-1.15; p =.82); 1.22 (95% CI, 0.94-1.59; p =.13); and 1.22 (95% CI, 1.07-1.39; p =.002) for hyperfractionated RT; accelerated RT without total dose reduction; and accelerated RT with total dose reduction, respectively. Conclusion Concomitant CRT and hyperfractionated RT are comparable to one another on indirect comparison in the radiotherapeutic management of locoregionally advanced HNSCC. Any form of acceleration (with or without total dose reduction) may not compensate fully for lack of chemotherapy. © 2014 Wiley Periodicals, Inc.

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