Shorter radiation schedule works as well for head and neck cancer

This Phase 3 trial compared two radiation schedules for patients with locally advanced head and neck squamous cell carcinoma. The study involved 792 patients across 12 centers. One group received a 20-fraction hypofractionated schedule delivering 55 Gy over 4 weeks. The other group received a 33-fraction accelerated normofractionated schedule delivering 66 Gy over 5.5 weeks. Both groups also received cisplatin. The main goal was to see if the shorter schedule was noninferior to the longer one regarding tumor control and late side effects. The trial passed the noninferiority test for both loco-regional tumor control and grade 3 or higher late adverse events. Overall survival and progression-free survival showed an absolute difference of less than or equal to 1.4 percentage points between the arms. Data for all outcomes remained blinded at the time of reporting. No serious adverse events were reported. Discontinuations were not reported. Tolerability was not reported. Funding or conflicts were not reported. This trial suggests a shorter radiation schedule may be a viable option for some patients, but readers should note the data was still blinded when reported.