Hyperthermia with radiation in the treatment of locally advanced head and neck cancer: a report of randomized trial.

BACKGROUND Head and neck cancer is the leading cause of male mortality due to cancer in India. Surgery, radiation alone or in combination has been the backbone of treatment strategies. Chemo-radiation has emerged as the standard of care in most types of head and neck cancer. This strategy has the advantage of maintaining both structure and functions, albeit with increased acute and delayed side effects. Radiation with hyperthermia can achieve the same objective without additional toxicities. MATERIALS AND METHODS A total of 56 patients were randomized to radiation therapy (RT) alone or RT-hyperthermia (RT-HT) arm. Twenty-six patients were included in RT alone arm and 28 patients in the RT-HT arm. Both groups were evenly matched for age, sex, and stage. Patients in both the arms received radiation to a dose of 66-70 Gy in 6.5-7 weeks. Patients in the study group received weekly HT. HT was started after impedance matching to last for 30 minutes. RESULTS Complete response was seen in 42.4% of RT alone group compare to 78.6% in the HT group. The difference was statistically significant ( < 0.05). Kaplan-Meir analysis of survival also showed a significant improvement in favor of RT-HT. No dose limiting thermal burns and excessive mucosal or thermal toxicity were recorded. CONCLUSION Radiofrequency (RF) based heating and radical radiation of head and neck cancers is better than in RT alone group. HT should be considered as a valid option wherever the facility for HT is available. This report should infuse greater confidence in radiation Oncologists to practice HT as an adjuvant treatment modality.