Clinical oncology (Royal College of Radiologists (Great Britain))
August 28, 2026 · via Europe PMC
A Multicentre Retrospective Cohort Study of Hypofractionated Radiotherapy in Head and Neck Cancer.
Miller D, Clarke K, Abdeltawab K, Zeniou A, Fouda S, Dormer J, Nathan K, Hunter B
AI summary — for doctors, generated from the abstract only
Hypofractionated radiotherapy of 55 Gy in 20 fractions was completed by 95% of head and neck cancer patients with toxicity comparable to normal fractionation.
What was studied
A multicentre retrospective study of 119 patients at two UK centres referred for 55 Gy in 20 fractions with VMAT between 2018 and 2025 (excluding early glottic cancers).
Key findings
- 113 patients (95%) completed treatment, although 57% had an ACE score of 2 or more and 37% a performance status of 2 or more
- At end of treatment, 64% had grade 3 mucositis, 45% grade 2 dysphagia and 62% grade 2 salivary toxicity
- 45% had gastrostomy tubes, 35% of which were removed within three months
- Early p16-positive oropharyngeal cancers had a 90% complete response rate and 85% 3-year overall survival
Clinical relevance
It supports shorter schedules, especially for patients who would find a 6-7 week course difficult.
Who should care
Limitations
A retrospective series with short follow-up, no comparator and a frail, selected population.
Consider 55 Gy in 20 fractions for appropriate head and neck patients, with close toxicity and nutrition support.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
AIMS
Many squamous cell carcinomas of the head and neck (HNSCC) can be cured with radical radiotherapy, but conventional fractionation schedules over 6-7 weeks can be difficult to tolerate. Since the COVID-19 pandemic, and recent HYPNO trial results, interest in hypofractionation (55 Gy in 20#s) has increased, but real-world efficacy and toxicity data are limited. We evaluated the use of hypofractionation across two U.K. centres since adoption of volumetric-modulated arc therapy (VMAT).
MATERIALS AND METHODS
Electronic healthcare record searches identified patients with HNSCC referred for 55 Gy in 20#s as the first definitive treatment, excluding early glottic cancers. Toxicity data were captured using the Radiation Therapy Oncology Group (RTOG) criteria at end of treatment and 4 weeks post-treatment. Time to gastrostomy removal, complete response rates, overall and recurrence-free survival were calculated.
RESULTS
119 patients were referred between January 2018 and August 2025, of whom 113 (95%) completed treatment. Sixty-seven (57%) had an ACE score of ≥2, and 43 (37%) had a performance status of ≥2. Most patients (76%) received treatment to the primary and bilateral neck. At end of treatment, 72 (64%) had G3 mucositis, 51 (45%) had G2 dysphagia, 43 (38%) had G2 skin toxicity, and 70 (62%) had G2 salivary toxicity. Fifty-four (45%) had gastrostomy tubes, 19 of which (35%) were removed within three months of completion. For early p16+ve oropharyngeal cancers, complete response rates were 90%, with 3-year overall survival (OS) rates of 85%.
CONCLUSION
Hypofractionation can be given safely with comparable toxicity to normofractionation outside of early glottic cancers.
DOI
10.1016/j.clon.2026.104332
PMID
42759386
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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