Issue Highlights

Article Outline

• Mature Results of a Randomized Trial of Accelerated Hyperfractionated Versus Conventional Radiotherapy in Head-and-Neck CancerPage 3
• A 10-Year Retrospective Review of a Nonrandomized Cohort of 458 Patients Undergoing Radical Radiotherapy or Cystectomy in Yorkshire, UKPage 119
• Prognostic Significance of Number of Positive Nodes: A Long-Term Study of One to Two Nodes Versus Three Nodes in Breast Cancer PatientsPage 180
• A Novel Dose Constraint to Reduce Xerostomia in Head-and-Neck Cancer Patients Treated With Intensity-Modulated RadiotherapyPage 269

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Mature Results of a Randomized Trial of Accelerated Hyperfractionated Versus Conventional Radiotherapy in Head-and-Neck CancerPage 3 

M.I. Saunders, A.M. Rojas, M.K.B. Parmar, S. Dische, for the Chart Trial Collaborators

Long-term results of a randomised trial comparing two contrasting courses of radiotherapy, one conventional over 6 1/2 weeks and the other accelerated over 2 weeks, showed similar control of local disease and patient survival. On the other hand, severe adverse side effects that appear over the course of months to years after radiotherapy, were less with accelerated radiotherapy (CHART). The schedule is particularly indicated for use in patients with low-risk disease and for those unable to withstand more aggressive treatments such as a course of radical chemo-radiotherapy.

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A 10-Year Retrospective Review of a Nonrandomized Cohort of 458 Patients Undergoing Radical Radiotherapy or Cystectomy in Yorkshire, UKPage 119 

N.P. Munro, S.K. Sundaram, P.M. T. Weston, L. Fairley, S.C. W. Harrison, D. Forman, R. Chahal

“This article reviewed the 10-year overall survival (death from any cause) for a cohort of 458 patients who underwent radical radiotherapy or surgery (radical cystectomy) for invasive bladder cancer in Yorkshire, in the UK, between 1993-6. Statistical analyses showed no significant difference in overall 10-year survival between those who underwent radiotherapy (22% alive) and surgery (24% alive). Female sex, performance status, hydronephrosis and clinical T stage were associated with an inferior outcome, while patient age, tumour grade, treatment delay and caseload factors were not significant. Although the cohort was non-randomised and the techniques for surgery and radiotherapy have changed significantly since 1996, such complete long-term data are rarely reported.”

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Prognostic Significance of Number of Positive Nodes: A Long-Term Study of One to Two Nodes Versus Three Nodes in Breast Cancer PatientsPage 180 

P. Tai, E. Yu, K. Joseph

Previous studies in breast cancer have generally analyzed patients with 1-3 positive nodes as a single group. This study of 755 patients found that the cancer-specific survivals of patients with 1 or 2 positive nodes were similar, and significantly better than those with 3 positive nodes. Hence survival among patients with 1-3 positive nodes reveals clearly relevant differences when separately analyzed. Differing treatment outcomes regarding the role of regional radiotherapy reported previously for 1-3 positive nodes in the literature might be due to the inclusive analysis of differing proportions of patients having 3 positive nodes with significantly worse outcomes.

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A Novel Dose Constraint to Reduce Xerostomia in Head-and-Neck Cancer Patients Treated With Intensity-Modulated RadiotherapyPage 269 

L. Strigari, M. Benassi, G. Arcangeli, V. Bruzzaniti, G. Giovinazzo, L Marucci

“this article investigates the predictors of incidence and duration of xerostomia (XT) in sixty-three head-and-neck cancer patients treated with intensity-modulated radiotherapy. Mean dose to both parotid and submandibular glands, taken as a whole organ (TG), correlates with XT as assessed by Radiation Therapy Oncology Group criteria, salivary output, and XT-related questionnaires. Our results suggest that TG mean dose is a candidate dose constraint for reducing XT, requiring considerably more validation in non-nasopharyngeal cancer patients.”