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Altered Fractionation and Radio-Sensitisation in Head and Neck Cancer Radiotherapy
Closed for proposals
Project Type
Project Code
E33030CRP
1549Approved Date
Status
Start Date
Expected End Date
Completed Date
17 December 2015Description
Tumours in the head and neck region represent around 7% of all cancer. Squamous cell carcinoma of the head and neck region (HNSCC) is among the most common malignant diseases worldwide, being a major cancer in many low and middle income countries particularly among men and smokers. Treatment of Head and Neck cancer is an important issue in radiation oncology worldwide, especially in low and middle income countries. By optimizing fractionation of radiotherapy and evaluating the role of radiosensitizer in a resource sparing combined modality approach, it is expected that Member States will benefit from the rational use of existing equipment and staff levels, decreasing costs, yet providing optimal treatment for patients. This CRP continues Agency’s research efforts which have improved the clinical practice in radiotherapy of locally advanced HNSCC cancer.
Objectives
To enhance MS capabilities to establish sound policies concerning radiotherapy and cancer treatment, and ensuring effective and efficient utilization of current and future advanced cancer radiotherapy treatment technologies
Specific objectives
The aim of the study was to determine the possible therapeutic gain when Nimorazole was given as a hypoxic radio-sensitizer in conjunction with accelerated fractionated radiotherapy in invasive squamous cell carcinoma of the larynx, pharynx and oral cavity and evaluate tolerance, compliance and toxicities of the combined treatment.
Impact
The CRP results showed the feasibility of using concomitant Nimorazole and radiotherapy in advanced head and Neck cancers with acceptable level of toxicities. The treatment of HNSCC by radiotherapy and concomitant Nimorazole was well tolerated and drop out rate for the patients during the treatment (experimental arm) was within the reasonable limits. Further, the out come of patients receiving concomitant treatment in terms of loco-regional failure and overall survival was better ( not statistically significant) when compared to radiotherapy alone.
The results of the study has set the stage for future studies with similar design. In light of the current standard of care for any future study , however, the comparative arm should be concurrent radiotherapy and chemotherapy.
Relevance
This CRP was planned to see if addition of a hypoxic radio- sensitizer Nimorazole to radiotherapy improved the outcome of treatment of advanced HNSCCs when compared to use of radiotherapy alone. This was based on encouraging preliminary results, as reported in literature. The study also tried to look at the feasibility using this combined treatment (Nimorazole and radiotherapy) with acceptable level of toxicities. It was expected that the results of this study would improve the treatment strategy of for HNSCC in Low and middle income countries.