Overall time and accelerated radiotherapy

There is now evidence that squamous cell carcinoma in the head and neck and in the lung has the capacity to rapidly proliferate and, in some cases, the tumour cell numbers may double in a few days. This can occur during a course of treatment and be the cause of radiation failure. By shortening the overall duration, the opportunity for this to occur is reduced.

f EORTC European Organization for Research and Treatment of Cancer

In a randomized controlled trial, the CHARTS regime, in which treatment is given 3 times on each of 12 consecutive days, proved superior to conventional radiotherapy in non-small cell lung cancer (NSCLC). A split course regime of accelerated radiotherapy was shown to be superior to conventional radiotherapy in head and neck cancer but there was some increase in normal tissue morbidity.

There is now evidence from randomized controlled clinical trials that a reduction of one week in the duration of radiotherapy in head and neck cancer gives major improvement without significant increase in late morbidity.

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