Impact of fraction size on locally advanced oropharyngeal and nasopharyngeal cancers treated with chemoradiation

In locally advanced head and neck squamous cell carcinomas, the addition of chemotherapy given concurrently with radiation has improved locoregional control and/or overall survival [1,2]. Classically, chemoradiation has used fraction sizes of 1.8–2Gy to a total dose of approximately 70Gy [1–3]. The National Comprehensive Cancer Network recommendations do not currently agree on the optimal fraction size to use with concurrent chemoradiation [4]. Given the benefit of altered fractionation radiotherapy regimens in the absence of chemotherapy [5–8], several groups have incorporated slightly hypofractionated regimens in which the predominant fraction size of 2.12Gy has been used.

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