Hypofractionated Accelerated Radiotherapy for Head and Neck Cancer in Fragile Patients.

Abstract

Radiotherapy combined with chemotherapy is the treatment of choice for locally advanced non-metastatic head and neck cancer. Elderly and frail patients cannot always tolerate this therapy and no clear guidelines exist for their treatment. This retrospective study aims to analyze the efficacy and safety of hypofractionated radiotherapy for these patients. A retrospective analysis of 65 patients treated with hypofractionated radiotherapy, using a regimen of 57.5 Gy in 23 fractions of 2.5 Gy. Most patients completed the prescribed treatment. Overall survival at 2 and 5 years was 55% and 33%. Locoregional control at 2 and 5 years was 76% and 51%, respectively. Performance status was an independent prognostic factor (p = 0.05). This radiotherapy schedule was well tolerated, showing a high rate of locoregional control and shortening the overall treatment time. Prospective studies are necessary to establish the most effective treatment for frail patients.