Palliative radiotherapy in recurrent head-and-neck tumors by a percutaneous superfractionated treatment schedule.

Abstract

A frequent problem in treatment of patients with head-and-neck tumors is recurrence in pre-irradiated areas, thus limiting dose for another full-course radiotherapy. We present our experience with a percutaneous superfractionated short-term radiotherapy regimen that may be useful for palliative irradiation. Twenty-three patients with head-and-neck tumor recurrence after radiotherapy or extensive tumor growth have been treated by a superfractionated regimen. At each of two subsequent days, eight fractions of 1 Gy were applied with an interfraction interval of 1 h, resulting in a total dose of 16 Gy. Time between the last fraction of the first day and the first fraction of the second day was 17 h. In 16 of 23 patients (70%), our irradiation schedule could achieve a palliative effect such as tumor necrosis or reduction of swelling or pain. Seven patients showed erythema (WHO I) at the end of the second day. Neither mucositis nor late effects of treatment were observed. Our superfractionated schedule is feasible without severe acute side reactions and can achieve a palliative effect in advanced or recurrent head-and-neck cancer.