Submit Your Article CMED MEACR meeting
Home Print this page Email this page Users Online: 665
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2012  |  Volume : 1  |  Issue : 3  |  Page : 118-126

A comparison of outcomes with 'Christie Regimen' and pure accelerated radiotherapy versus conventional radiation in locally advanced squamous cell carcinoma of head and neck: A randomized controlled study

1 Department of Radiotherapy, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
2 Department of Radiotherapy, Burdwan Medical Hospital, Burdwan, West Bengal, India

Correspondence Address:
Shyam Sharma
Room No 104, Institute of Post Graduate Medical Education and Research and SSKM Hospital, 240, A.J.C Bose Road, P/S Bhowanipore, Kolkata - 700 020, West Bengal
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Rights and PermissionsRights and Permissions

Context and Aim: Radiotherapy is alternative to concurrent chemoradiation or surgery for locally advanced squamous cell carcinoma of head and neck (LAHNSCC) due to comorbid conditions. The aim of this study was to compare efficacy and toxicity among hypofractionated, pure accelerated and conventional radiotherapy schedules. Settings and Design: Interventional randomized controlled study. Materials and Methods: Between May 2008 and May 2012, 132 LAHNSCC patients, AJCC stages III to IVB, creatinine clearance <60 ml/min, age more than 50 years, comorbidities like uncontrolled diabetes, cardiac disease, ECOG 3 and 4, or combination of these were randomized into three arms: Arm A, "Christie Regimen", 50 Gray (Gy) in 16 fractions, 3.125 Gy per fraction over 3 weeks; Arm B, 66 Gy in 33 fractions in 6 fractions per week in 5.5 weeks; and Arm C, 66 Gy in 33 fractions, 5 fractions per week, in 6.5 weeks. The endpoints of the study were overall response (ORR = complete response + partial response), diseasefree survival (DFS), toxicities, and overall survival (OS). Statistical Analysis Used: All statistical tests were done using ANOVA. OS and DFS were calculated using KaplanMeier analysis. Result: ORRs were comparable in all arms, P value = 0.401. DFS were in favor of altered radiation, P value = 0.034. Acute Grade 3 cutaneous toxicity (P value = 0.018) and mucositis (P value = 0.011) were high with altered fractionation. Chronic grade 2 and 3 toxicities were higher in altered fractionations. Conclusion: There was no difference in the ORR between three arms but DFS was in favor of altered fractionation arms with manageable toxicity. Both altered fractionation had short overall treatment time which is radiobiologically superior and is beneficial for centers like ours where the patient load is much higher than the facility available.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded174    
    Comments [Add]    

Recommend this journal