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Purpose: To assess the loco regional response and toxicity of patients to concurrent chemo-radiation with 6 fractions/week using Intensity Modulated Radiotherapy in locally advanced head and neck cancers. (oropharynx and hypopharynx). Materials and Methods: 20 patients with Stage III and stage IV, squamous cell carcinoma of Head and neck were enrolled. Target Volume Delinetion was done in accordence with Danish Head and Neck cancer group (DAHANCA) contouring guidelines. Differential radiation dose of 70 Gy, 63Gy and 56 Gy in 35 fractions using IMRT, delivered to GTV, CTV1 and CTV2 with weekly cisplatin with weekly assessment of response and toxicity. Results: The median age of the patients was 54 years ranging from 40 to 65 years. 14 and 6 patients had Hypopharyngeal and Oropharyngeal malignancy of squamous cell origin. 95% of patients received 70 Gy in 35 fractions with 4 cycles of concurrent Cisplatin. 18 patients completed treatemnt within 45 days of OTT. 16 patients had complete response and 4 had partial response. Grade I, II dermatitis was observed in 70% and 30% of patients, respectively. 5 patienst developed Grade 2 and 1 patinet developed grade 3 leucopenia. 2 patients had weight loss of more than 10%. 85% oforopharyngeal cancers and 67% of hypopharyngeal cancers showed complete response. Nodal response was 100% complete in N1 & N2a, 92% and 0% in N2b and N3 lesions respicyively. TNM stage group wise the complete response rates were 100% in stage III, 92% & 0% IVA & IVB. Conclusion: Accelerated fractionation with IMRT and concurrent chemotherapy is a feasible in locoregionally adanced head and neck cancers with acceptable toxicities and good locoregional response rates.

Altered Fractionation Intensity Modulated Radiotherapy with concurrent chemotherapy in head and neck cancer : a feseability study