HFX Improves LRC, OS for Patients With Locally Advanced SCC

Classic Article Review  – Background: In a galaxy long gone, before the domination of concurrent chemoradiation, definitive head and neck radiation was fractionated 4 ways. Standard (1.8 to 2.0 Gy/day), the University of Florida BID method, the CC Wang split BID method, and the MD Anderson concomitant boost method. Objective: To evaluate 4 different methods of fractionation for definitive radiation treatment for head and neck cancers. Design: 4-arm, prospective randomized trial run by the Radiation Therapy Oncology Group (now NRG). Participants: Patients with untreated, locally advanced squamous cell cancers of the oral cavity, oropharynx, larynx, and hypopharynx were eligible. Methods: There were 3 experimental arms, and all were compared to the standard arm, rather than 4 equal arms being compared to each other. Standard fractionation (SFX) was 70 Gy/2 Gy per fraction, 5 days a week (7 weeks). Hyperfractionation (HFX) was 1.2 Gy BID, 5 days a week to 81.6 Gy (7 weeks); acceler more...