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Faster radiotherapy more effective in head and neck cancer, trial shows

The world's largest trial in accelerated radiotherapy for head and neck cancer the DAHANCA trial proves conclusively that increasing the number of treatments per week from five to six can benefit patients.

The research is published tomorrow (Saturday 20 September) in The Lancet medical journal[1] and the results will also be presented next week at ECCO 12 the European Cancer Conference[2], taking place in Copenhagen, Denmark.

Principal investigator Professor Jens Overgaard, from Aarhus University Hospital, Aarhus, Denmark, said that results from DAHANCA meant that the standard radiotherapy treatment for head and neck cancer had now changed.

In the trial, 1476 head and neck cancer patients were randomised to receive the same amount of radiotherapy per week, the only difference between the groups being the frequency with which they received it. One group had five treatments per week, and the other six. Overall, the results showed a benefit in tumour control of 60% in the 5 x week group, and 70% in the group receiving six treatments. The 6 x week group also showed better voice conservation in the patients with laryngeal cancer (80% as opposed to 68%). The patients were at different stages of the disease, from early to very advanced, but all were indicated for primary radiotherapy.

"Although all patients in the accelerated treatment arm did better," said Professor Overgaard, "some did better than others, and we are currently trying to identify those groups where the benefit is largest. It appears to be linked to two factors a high degree of expression of epidermal growth factor receptor (EGFR) and a good differentiation of the tumour."

An unpublished meta-analysis of trials[3] of modified fractionated radiotherapy in head and neck cancer, with about 8000 patients in all, also supports these findings, he said. "There are no shades of grey", said Professor Overgaard. These findings are unequivocal accelerated treatment is de
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Contact: Margaret Willson
m.willson@mwcommunications.org.uk
44-153-677-2181
Federation of European Cancer Societies
18-Sep-2003


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