{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:30:35Z","timestamp":1786649435482,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In our country, head and neck cancers account for about a third of all cancers. Moreover, the patients typically present in advanced stages, which entails intensive multimodality therapy; but there is not much scope for improved survival outcomes. In view of this, a study was conducted to know the effects of treatment intensification, wherein moderately accelerated fractionation radiotherapy was given to patients presenting with advanced cancer of head and neck. This treatment was further intensified by accompanying radiation with concurrent cisplatin chemotherapy in daily doses. The control arm received the current standard therapy of conventional fractionation radiotherapy with weekly cisplatin chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The primary objective of the study was to determine the prospect of tumor control (TC), disease-free survival (DFS), and overall survival (OS). The secondary objective was to study acute toxicity and late toxicity of the highest grade in both treatment groups. The study was conducted on a total of 60 patients who presented with locally advanced squamous cell carcinoma of the head and neck. The 30 patients in the control group received conventional fractionated radiotherapy (five fractions per week) with weekly cisplatin chemotherapy (40 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), whereas the remaining 30 in the study group received moderately accelerated radiotherapy (six fractions per week with same treatment field) along with daily cisplatin chemotherapy (6 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) with a reduction in treatment time by 1 week.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The overall response to therapy assessed as TC, DFS, and OS was compared, and no statistically significant difference between the two treatment arms was observed. However, the mean overall treatment time was reduced in the study group to 45 days as compared with 49 days in the control group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). The acute toxicities of xerostomia (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.057) and skin (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.052) and late toxicity of aspiration\/laryngeal toxicity (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002) were higher in grade and number in the study group with accelerated fractionation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Hence, the study results suggest that it is a feasible option to combine the therapeutic benefits of accelerated fractionation radiotherapy with concurrent chemotherapy in patients with locally advanced head and neck carcinomas. There is a significant decrease in the overall treatment time and a considerable reduction in the load on the resource-constrained healthcare system. It would be equitable to point out that higher grade of few toxicities in the acceleration arm are likely due to doses to organs at risk being intensified with accelerated fractionation, which can now be delivered in a controlled manner with the latest high precision techniques, resulting in improved toxicity profile and quality of life which is the way forward for future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijc.ijc_155_21","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T03:00:07Z","timestamp":1687143607000},"page":"262-272","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A comparative study of the treatment outcome of moderately accelerated radiation fractionation (with concurrent chemotherapy in daily dosing) to conventional chemo-radiotherapy in locally advanced head and neck cancers: Supportive in a resource constrained environment"],"prefix":"10.4103","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3816-9683","authenticated-orcid":false,"given":"Chhavi","family":"Arora","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Army Hospital R and R, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5172-2025","authenticated-orcid":false,"given":"Neelam","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Army Hospital R and R, New Delhi, India"},{"name":"Commanding Officer, Military Hospital Abohar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8589-2049","authenticated-orcid":false,"given":"Amul","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Army Hospital R and R, New Delhi, India"},{"name":"Commandant Military Hospital Bareilly, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1032-037X","authenticated-orcid":false,"given":"Tejas N.","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Army Hospital R and R, New Delhi, India"},{"name":"Department of Radiation Oncology, Command Hospital (Eastern Command), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,5,15]]},"reference":[{"key":"R1-20260426","doi-asserted-by":"crossref","first-page":"699044","DOI":"10.3389\/fphar.2021.699044","article-title":"Phytochemicals as Potential Chemopreventive and Chemotherapeutic Agents for Emerging Human Papillomavirus\u2013Driven Head and Neck Cancer: Current Evidence and Future Prospects","author":"Aggarwal","year":"2021","journal-title":"Front Pharmacol"},{"key":"R2-20260426","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5005\/jp-journals-10001-1132","article-title":"Head and neck cancer burden in India","volume":"4","author":"Kulkarni","year":"2013","journal-title":"Int J Head Neck Surg"},{"key":"R4-20260426","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1002\/ijc.11114","article-title":"Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal and esophageal cancers in Indian men","volume":"105","author":"Znaor","year":"2003","journal-title":"Int J Cancer"},{"key":"R5-20260426","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ejmp.2009.11.004","article-title":"Stochastic modelling of the role of cisplatin in altered fractionation schedules for head and neck cancer","volume":"26","author":"Marcu","year":"2010","journal-title":"Phys Med"},{"key":"R6-20260426","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S0140-6736(06)69121-6","article-title":"Hyperfractionated or accelerated radiotherapy in head and neck cancer: A meta-analysis","volume":"368","author":"Bourhis","year":"2006","journal-title":"Lancet"},{"key":"R7-20260426","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/S1470-2045(10)70072-3","article-title":"Five versus six fractions of radiotherapy per week for squamous-cell carcinoma of the head and neck (IAEA-ACC study): A randomised, multicentre trial","volume":"11","author":"Overgaard","year":"2010","journal-title":"Lancet Oncol"},{"key":"R8-20260426","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/S0140-6736(00)90011-4","article-title":"Chemotherapy added to locoregional treatment of head and neck squamous cell carcinoma: Three meta-analysis of updated individual data. 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