Comparative Study Between Accelerated Fractionation with Concomitant Chemotherapy Versus Conventional Chemoradiation in Locally Advanced Head and Neck Cancer

Background: Most head and neck cancers arise from the mucosal epithelium of the oral cavity, pharynx, and larynx, and are collectively referred to as head and neck squamous cell carcinoma (HNSCC).Early-stage HNSCC are managed by surgery alone where whereas locally advanced cancers require multimodal treatment which involves surgery followed by adjuvant radiotherapy(RT) or chemoradiotherapy(CRT).Methods: The present study was conducted at the State Cancer Institute, Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, MP, India.About 60 patients of either sex, randomized into two groups of 30 patients in each group fulfilling the inclusion and exclusion criteria were scheduled to undergo radiation with Cisplatin.Arm A patients received accelerated fraction, while Arm B received conventional fraction.Result: Most patients in both arms were males aged 50-60.In both arms, most patients had primary lesions in the oral cavity and were classified as stage III.Mucositis was more severe in Arm A than in Arm B. All of the patients in both arms were suffering from dysphagia during treatment.Complete response was achieved by 55.56% of patients in Arm A and 48.57% in Arm B. Conclusion: It was concluded that an accelerated regimen could be preferred over a conventional one per the clinical response observed and toxicity management.Disease-free survival can be predicted using a large sample size and time.