Feasibility and Acute Toxicity of Seven Fractions per Week Accelerated Radiotherapy with or without Concurrent Chemotherapy in Laryngopharyngeal Squamous Cell Carcinoma: A Pilot Study
Ravi Kannan, Gopal Dutta, Ramamoorthy Ravichandran, Kapil Malik, Vijayakanth Subramanian, Talagadadeevi V. S. S. K. Bharath, Abhishek Kesha, Tarani Mondal, Lamlynti Dkhar, Soumya Brata DebBackground:
Prolonged overall treatment time in laryngopharyngeal squamous cell carcinoma contributes to accelerated tumor repopulation and poorer outcomes. In resource-limited settings, socioeconomic factors further increase treatment interruptions. Accelerated radiotherapy may reduce treatment duration, but concerns regarding acute toxicity remain.
Objectives:
The objective of this study was to assess the feasibility and acute toxicity of a seven-fractions-per-week accelerated radiotherapy regimen, with or without concurrent chemotherapy, in laryngopharyngeal squamous cell carcinoma.
Methods:
This prospective pilot study included 92 patients with stage I–IV laryngopharyngeal squamous cell carcinoma treated between June 2020 and March 2021 at a tertiary cancer center in Northeast India. Patients received 70 Gy in 35 fractions delivered 7 days/week, with weekly cisplatin (40 mg/m 2 ) when indicated. Treatment was delivered using two-dimensional telecobalt radiotherapy with aluminum tissue compensation. Acute toxicity was assessed weekly using Radiation Therapy Oncology Group criteria.
Results:
Grade 3 mucositis occurred in 23.9% of patients and Grade 3–4 skin toxicity in 17.4%. Eighteen patients (19.6%) completed planned chemoradiation within 35 days. At 3 months, 50% achieved complete clinical response at both primary and nodal sites. Median overall survival was 841 days, with 1- and 2-year survival rates of 71.4% and 53.8%, respectively.
Conclusion:
Seven-day-per-week accelerated radiotherapy appears conditionally feasible with acceptable acute toxicity in resource-constrained settings. Further randomized studies are warranted to evaluate long-term outcomes.