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Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma The ARTSCAN study

Zackrisson, Bjorn; Nilsson, Per LU ; Kjellén, Elisabeth LU ; Johansson, Karl-Axel; Modig, Hans; Brun, Eva LU ; Nyman, Jan; Friesland, Signe; Reizenstein, Johan and Sjodin, Helena, et al. (2011) In Radiotherapy and Oncology 100(1). p.41-48
Abstract
Background and purpose: Studies on accelerated fractionation (AF) in head and neck cancer have shown increased local control and survival compared with conventional fractionation (CF), while others have been non-conclusive. In 1998 a national Swedish group decided to perform a randomised controlled clinical study of AF. Materials and methods: Patients with verified squamous cell carcinoma of the oral cavity, oropharynx, larynx (except glottic T1 -T2, N0) and hypopharynx were included. Patients with prior chemotherapy or surgery were excluded. Patients were randomised to either CF (2 Gy/day, 5 days/week for 7 weeks, total dose 68 Gy) or to AF (1.1 Gy + 2.0 Gy/day, 5 days/week for 4.5 weeks, total dose 68 Gy). An extensive quality assurance... (More)
Background and purpose: Studies on accelerated fractionation (AF) in head and neck cancer have shown increased local control and survival compared with conventional fractionation (CF), while others have been non-conclusive. In 1998 a national Swedish group decided to perform a randomised controlled clinical study of AF. Materials and methods: Patients with verified squamous cell carcinoma of the oral cavity, oropharynx, larynx (except glottic T1 -T2, N0) and hypopharynx were included. Patients with prior chemotherapy or surgery were excluded. Patients were randomised to either CF (2 Gy/day, 5 days/week for 7 weeks, total dose 68 Gy) or to AF (1.1 Gy + 2.0 Gy/day, 5 days/week for 4.5 weeks, total dose 68 Gy). An extensive quality assurance protocol was followed throughout the study. The primary end point was loco-regional tumour control (LRC) at two years after treatment. Results: The study was closed in 2006 when 750 patients had been randomised. Eighty-three percent of the patients had stages III-IV disease. Forty eight percent had oropharyngeal, 21% laryngeal, 17% hypopharyngeal and 14% oral cancers. There were no significant differences regarding overall survival (OS) or LRC between the two regimens. The OS at two years was 68% for AF and 67% for CF. The corresponding figures for LRC were 71% and 67%, respectively. There was a trend towards improved LRC for oral cancers treated (p = 0.07) and for large tumours (T3-T4) (p = 0.07) treated with AF. The AF group had significantly worse acute reactions, while there was no significant increase in late effects. Conclusion: Overall the AF regimen did not prove to be more efficacious than CF. However, the trend towards improved results in AF for oral cancers needs to be further investigated. (c) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 41-48 (Less)
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subject
keywords
Head and neck cancer, Randomised trial, Radiotherapy, Accelerated, fractionation
in
Radiotherapy and Oncology
volume
100
issue
1
pages
41 - 48
publisher
Elsevier
external identifiers
  • wos:000295243200007
  • scopus:80051784833
ISSN
1879-0887
DOI
10.1016/j.radonc.2010.12.010
language
English
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yes
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93993ce6-5c71-4943-935d-a95a0a94420c (old id 2179786)
date added to LUP
2011-11-01 07:47:15
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2017-04-16 03:02:48
@article{93993ce6-5c71-4943-935d-a95a0a94420c,
  abstract     = {Background and purpose: Studies on accelerated fractionation (AF) in head and neck cancer have shown increased local control and survival compared with conventional fractionation (CF), while others have been non-conclusive. In 1998 a national Swedish group decided to perform a randomised controlled clinical study of AF. Materials and methods: Patients with verified squamous cell carcinoma of the oral cavity, oropharynx, larynx (except glottic T1 -T2, N0) and hypopharynx were included. Patients with prior chemotherapy or surgery were excluded. Patients were randomised to either CF (2 Gy/day, 5 days/week for 7 weeks, total dose 68 Gy) or to AF (1.1 Gy + 2.0 Gy/day, 5 days/week for 4.5 weeks, total dose 68 Gy). An extensive quality assurance protocol was followed throughout the study. The primary end point was loco-regional tumour control (LRC) at two years after treatment. Results: The study was closed in 2006 when 750 patients had been randomised. Eighty-three percent of the patients had stages III-IV disease. Forty eight percent had oropharyngeal, 21% laryngeal, 17% hypopharyngeal and 14% oral cancers. There were no significant differences regarding overall survival (OS) or LRC between the two regimens. The OS at two years was 68% for AF and 67% for CF. The corresponding figures for LRC were 71% and 67%, respectively. There was a trend towards improved LRC for oral cancers treated (p = 0.07) and for large tumours (T3-T4) (p = 0.07) treated with AF. The AF group had significantly worse acute reactions, while there was no significant increase in late effects. Conclusion: Overall the AF regimen did not prove to be more efficacious than CF. However, the trend towards improved results in AF for oral cancers needs to be further investigated. (c) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 41-48},
  author       = {Zackrisson, Bjorn and Nilsson, Per and Kjellén, Elisabeth and Johansson, Karl-Axel and Modig, Hans and Brun, Eva and Nyman, Jan and Friesland, Signe and Reizenstein, Johan and Sjodin, Helena and Ekberg, Lars and Loden, Britta and Mercke, Claes and Fernberg, Jan-Olof and Franzen, Lars and Ask, Anders and Persson, Essie and Wickart-Johansson, Gun and Lewin, Freddi and Wittgren, Lena and Bjor, Ove and Bjork-Eriksson, Thomas},
  issn         = {1879-0887},
  keyword      = {Head and neck cancer,Randomised trial,Radiotherapy,Accelerated,fractionation},
  language     = {eng},
  number       = {1},
  pages        = {41--48},
  publisher    = {Elsevier},
  series       = {Radiotherapy and Oncology},
  title        = {Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma The ARTSCAN study},
  url          = {http://dx.doi.org/10.1016/j.radonc.2010.12.010},
  volume       = {100},
  year         = {2011},
}