Optimized Hypofractionation can Markedly Improve Tumor Control and Decrease Late Effects for Head and Neck Cancer

Radiotherapy of rapidly-growing HPV-negative head and neck cancers (HNC) remains challenging. We use systematic radiobiological optimization, focusing on improved models of accelerated repopulation, to identify optimized fractionation schemes that markedly improve tumor control probability (TCP) as well as sharply decreasing the late normal tissue complication probability (LNTCP), compared with standard 35 × 2 Gy fractionation. An optimized hypofractionated HNC schedule of 18×3.0 Gy is predicted to substantially increase TCP and decrease LNTCP.

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