New: NCI-funded clinical trial search
Mednet Logo

Why is accelerated hyperfractionated RT still being performed in NRG trials such as HN005?

Didn’t 0129 establish no difference between conventional vs Accelerated RT with the same Cisplatin regimen? Are there still thoughts of benefit with Acc fractionation? In practice do most perform conventional?
Community PollStarted

What dose regimen do you use for locally advanced H&N WITH chemotherapy?

186 physicians have voted

Join Mednetto vote and see how they answered.

5 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Moffitt Cancer Center
Answered on

To go back a little bit in history, RTOG 1016 was designed prior to the results of RTOG 0129 were available. In the Bonner trial, most patients were treated with accelerated fractionation + cetuximab, and seemed to have better outcomes than those with conventional fractionation. Therefore, in the ab...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Medical University of South Carolina (Charleston)
Answered on

I agree with all the points made by my colleagues in their posts.

I sparingly use 72 Gy concomitant boost MDACC regimen. I prefer hyperfractionation 1.2 Gy BID (UF style) over 72 Gy concomitant boost because of the results of RTOG 9003. However, it is sometimes difficult for patients to come twice ...

Join for free or sign in to see the full answer

Mednet Member
Mednet Member
Radiation Oncology · Sacred Heart Cancer Center
Answered on · Updated on

Much has been written regarding the proof that AFX (and I lump all forms here unless specifically noted) is PROVEN to be no better than SFX in the context of q3wk cisplatin. But I ask for a deeper education from those with the knowledge on how we have excused some facts on the way to categorical sta...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on

Not only did 129 show no survival benefit to AFX, but there was a suggestion of greater toxicity. The 5-y rate of feeding tube was 13% vs 6% (p=.08). Subsequently, 522 used AFX in both arms, and a recent update presented at the combo HN meeting showed long term results of feeding tube rates > 10% in...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · UT Southwestern School of Medicine
Answered on

From a clinical trial standpoint, there is strong logic to using two cycles of bolus cisplatin in both arms. In this way, the only difference between the 70 Gy and 60 Gy arms is the total dose. The chemotherapy is literally identical, and thus the only difference—if any—would be related to the total...

Join for free or sign in to see the full answer