To hyperfractionate or not to hyperfractionate-Is it really a question?

Abstract

Despite technical advances the last decade, patients with HPV/p16 negative head and neck cancer (being smokers and having affected performance and co-morbidities), still have a poor outcome after treatment. Hyperfractionated radiotherapy with concurrent cisplatin might be a reasonable way to pursue for improving their outcome. This strategy requires that adequate supportive care is available. The term hyperfractionated radiotherapy (HFR) is used when radiotherapy is delivered in doses below 1.8-2.0 Gy per fraction. The rationale for doing so can be found in the differences in intrinsic radiosensitivity between tumours and late responding normal tissues. A small dose per fraction will tend to increase the therapeutic ratio between tumour and critical normal tissue and therefore allow a higher tumour dose to be given at the same level of normal tissue damage. This principle been extensively explored for squamous cell carcinomas arising in the head and neck region. The of HFR