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For Release: November 1, 1999
CHANGING TREATMENT TIME OR TOTAL DOSE MEANS IMPROVEMENTS FOR SOME PATIENTS WITH HEAD AND NECK CANCER.
Reducing the total time of radiation treatments without decreasing the total dose or increasing the total dose without changing the total treatment time led to an improvement over standard treatment for patients with locally advanced head and neck cancer, a study by the Radiation Therapy Oncology Group (RTOG) indicates.
The nationwide study included 1,073 patients who had cancer confined to the head and neck area. It found that treating a patient over a shorter period of time (six weeks) with part of that treatment being once a day and the other part being twice a day, five days a week, to a total radiation dose of 72 Gy was better than standard treatment, says Karen Fu, M.D., chair of the RTOG study. The local tumor control rate at two years for these patients was 54.5 percent compared to 46 percent for standard treatment . Treating a patient once a day, five days a week for a total dose of 70 Gy in seven weeks is currently the standard treatment, says Dr. Fu, professor of radiation oncology at the University of California in San Francisco, CA.
Patients on the study who were treated twice a day, five days a week for seven weeks to a higher total dose of 81.6 Gy also did better than those undergoing standard treatment, she says. The local control rate at two years for these patients was 54.4 percent.
In addition to the improved local control rates, there was a trend toward better disease-free survival rates for those patients. Longer follow-up of these patients will show whether that trend becomes significant, says Dr. Fu.
Since the dose was increased there was an increase in treatment side effects, notes Dr. Fu. Patients were able to tolerate the side effects, she says. There was no evidence of increased persistent late toxicities, she adds.
This was one of the largest randomized controlled trials of the treatment of head and neck cancer mounted in the U.S. in the past 20 years. As such it has great validity, says Dr. Fu. The RTOG plans to conduct additional studies to further improve the efficacy and decrease the toxicity of these new treatment designs, says Dr. Fu.
Dr. Fu presented the results of the RTOG study on November 1 at the ASTRO annual meeting in San Antonio, TX.
The American Society for Therapeutic Radiology and Oncology (ASTRO) is the largest radiation oncology society in the world, with more than 5,000 members. As a leading organization in radiation oncology, biology and physics, the society's goals are to advance the scientific base of radiation therapy and to extend the benefits of radiation therapy to those with cancer.
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