Are any centers routinely using 55 Gy in 20 fractions with chemotherapy for definitive treatment of head and neck cancer following presentation of the HYPNO study?
I would not consider 55 Gy in 20 fractions a standard approach. The comparator arm was not standard practice in the US (66 Gy in 33 fractions with 5 weekly cycles of cisplatin at 35 mg/m2). Both the total RT dose (66 Gy < 70 Gy) and the total cisplatin dose (cumulative dose 175 mg/m2, less than the ...
I always think the most prudent approach is to wait for the final publication, and thus the peer-review process to be complete, before making widespread changes to my routine practice. The level of scrutiny an abstract goes through is very different than that of a manuscript in a high-quality journa...
In this randomized study of hypofractionated vs standard chemo-RT performed mostly in developing countries, with almost all patients being smokers and likely having non-HPV related HNC, the hypofractionated group tumor-related outcome was non-inferior to standard fractionation, and early adverse eve...
No, not routinely using. I have used this approach once on an older patient who would only do RT if 4 weeks (vs 7 weeks). Agree with previous posts — no change in practice until manuscripts are published, and even then I would want further validation studies comparing to the US regimens. These non-s...
We are not, and I am skeptical that the fractionation will, at least in the US, be widely accepted. I think the main "practice change" will be comfort level in this schedule if there are mitigating circumstances (social or medical) where a 7-week schedule will be a major challenge, while a 4-week sc...
Yes, at Mayo Clinic, we frequently use a hypofractionated treatment course for head and neck cancer, of which HYPNO is an option for a patient off trial. In our practice context, where HPV negative patients often come from rural settings some distance away from treatment centers, hypofractionated re...
As all have stated, no this would not be the standard of care for definitive radiation and chemotherapy. I agree with the others above.
However, this abstract does support the use of chemotherapy in patients who may not be candidates for standard of care (frail, or older, or those with M1 disease an...
No, the standard of care is well established. An abstract is insufficient to change practice. The full manuscript with review allows for reflection and commentary. Multiple options exist for hypofractionation that are even more convenient, Piras et al., PMID 34868976. Using chemotherapy doses below ...