Top Line: Are late swallowing outcomes after mild hypofractionation for oropharyngeal cancer similar to standard fractionation?
The Study: This multicenter observational study from the UK compared swallowing function between patients treated with mild hypofractionated (65-66 Gy in 30 fractions) and standard fractionated (70 Gy in 35 fractions) radiation alone for oropharyngeal squamous cell carcinoma. 233 patients were treated between 2015 and 2018 at three different centers. One center only used 70 Gy in 35 fractions, one center used both 70Gy/35 and 65 Gy in 30 fractions, and one center only used 66 Gy in 30 fractions. Most patients (58.4%) were treated with hypofractionation. In general, these patients did not receive concurrent chemotherapy due to age (31% >70) or comorbidities. The rate of locoregional control was 72%, and the rate of overall survival was 65% with no differences between groups for either outcome. Swallowing function was assessed using the MD Anderson Dysphagia Index (MDADI), which was sent to patients who were cancer free at least 2 years out from treatment. There were no differences in patient-reported swallowing function between groups in overall assessment or MDADI subscales.
TBL: This study of patients with oropharyngeal cancer who were not candidates for concurrent chemotherapy suggests that treatment outcomes and swallowing function after 65-66 Gy in 30 fractions is comparable to standard fractionation. | Price, Radiother Oncol 2022