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Head and Neck Cancers • Radiation Oncology
What is the best fractionation for head and neck patients who cannot receive systemic therapy due to KPS or medical comorbidities?
Do you have a KPS or other cutoffs that would deter you from using accelerated fractionation due to concern for toxicity?
Answer from: Radiation Oncologist at Academic Institution
In my experience, using the DAHANCA regimen (once daily 4 days a week, twice daily once a week), but treating only PTV1 in the second daily fraction, is quite well tolerated. The original DAHANCA treated all targets twice daily. However, using IMRT it is possible to avoid prophylactically irradiated...
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Answer from: Radiation Oncologist at Academic Institution
If a patient has a cancer appropriate for definitive chemoradiation and has indications for chemotherapy but is not considered medically able to have chemotherapy, then I recommend accelerated fractionation. If the KPS is not even high enough for accelerated fractionation, then the goal should proba...
Answer from: Radiation Oncologist at Community Practice
See MARCH update in the Lancet Oncology