Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)

PURPOSEHead and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (H...

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Main Authors: Ajeet Kumar Gandhi, Supriya Chopra, Madhup Rastogi, Indranil Mallick, Misael C. Cruz, Koichi Yasuda, Ying Ying Sum, Yasushi Nagata, Hong-Gyun Wu, Gregorius B. Prajogi, Henry Kodrat, Mingwei Ma, Asif Nisar, Imjai Chitapanarux
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-04-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO-24-00349
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author Ajeet Kumar Gandhi
Supriya Chopra
Madhup Rastogi
Indranil Mallick
Misael C. Cruz
Koichi Yasuda
Ying Ying Sum
Yasushi Nagata
Hong-Gyun Wu
Gregorius B. Prajogi
Henry Kodrat
Mingwei Ma
Asif Nisar
Imjai Chitapanarux
author_facet Ajeet Kumar Gandhi
Supriya Chopra
Madhup Rastogi
Indranil Mallick
Misael C. Cruz
Koichi Yasuda
Ying Ying Sum
Yasushi Nagata
Hong-Gyun Wu
Gregorius B. Prajogi
Henry Kodrat
Mingwei Ma
Asif Nisar
Imjai Chitapanarux
author_sort Ajeet Kumar Gandhi
collection DOAJ
description PURPOSEHead and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (HFRT) have not been practiced uniformly across centers in different parts of the world. Countries in Asia share common cancer demographics, and we designed this survey for Federation of Asian Radiation Oncology (FARO) member countries to understand the usage and challenges in the delivery of ALFT in HNCs.MATERIALS AND METHODSA 21-point electronic survey (Federation of Asian Radiation Oncology Research Network [FERN]-S-005) was designed by the FERN and was circulated through the FARO research secretariat to the FARO council member countries and the responses were collected between August and November 2023.RESULTSTwelve of 14 member countries (85.7%) responded to the survey. Twenty-seven responses were received and 78% of the respondents belonged to government/teaching academic institute. 4/27 (14.8%) reported never using HYPO-RT for any of the clinical subsite of HNCs, while the majority (85.2%) used it for glottic cancers and 22% also used it for postoperative setting. Majority (77.7%) used a fractionation schedule with dose per fraction ranging between 2.2 and 2.5 Gy. 6/27 (22.2%) used AFRT for definitive setting and five of these also used concurrent chemoradiotherapy. 4/27 (14.8%) centers reported using HFRT. The most common reason (62.9%) for the limited usage of AFRT/HFRT was reported to be logistical, such as unavailability of machine slots, patient load, and so on.CONCLUSIONThe result of the survey suggests that among the ALFT strategies for HNCs, HYPO-RT schedules have common interest and feasibility among the FARO member countries and also highlights the challenges in the delivery of AFRT/HFRT in the Asian region.
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spelling doaj-art-6746b352fe124c18b49a2a61d3f7ac762025-08-20T03:06:13ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-04-011110.1200/GO-24-00349Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)Ajeet Kumar Gandhi0Supriya Chopra1Madhup Rastogi2Indranil Mallick3Misael C. Cruz4Koichi Yasuda5Ying Ying Sum6Yasushi Nagata7Hong-Gyun Wu8Gregorius B. Prajogi9Henry Kodrat10Mingwei Ma11Asif Nisar12Imjai Chitapanarux13Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IndiaDepartment of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, IndiaDepartment of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IndiaDepartment of Radiation Oncology, Tata Medical Center, Kolkata, IndiaCentral Luzon Integrated Oncology Center and Cancer Institute Sacred Heart Medical Center, Pampanga, PhilippinesDepartment of Radiation Oncology, Hokkaido University Hospital, Sapporo, JapanDepartment of Radiotherapy and Oncology, Penang General Hospital, George Town, MalaysiaDepartment of Radiation Oncology, Chugoku Rosai Hospital, Emeritus Professor, Hiroshima University, Kure, JapanDepartment of Radiation Oncology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South KoreaDepartment of Radiation Oncology, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Radiation Oncology, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Radiation Oncology, Peking University First Hospital, Beijing, ChinaClinical and Radiation Oncologist, AECH NORI, Islamabad, PakistanDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandPURPOSEHead and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (HFRT) have not been practiced uniformly across centers in different parts of the world. Countries in Asia share common cancer demographics, and we designed this survey for Federation of Asian Radiation Oncology (FARO) member countries to understand the usage and challenges in the delivery of ALFT in HNCs.MATERIALS AND METHODSA 21-point electronic survey (Federation of Asian Radiation Oncology Research Network [FERN]-S-005) was designed by the FERN and was circulated through the FARO research secretariat to the FARO council member countries and the responses were collected between August and November 2023.RESULTSTwelve of 14 member countries (85.7%) responded to the survey. Twenty-seven responses were received and 78% of the respondents belonged to government/teaching academic institute. 4/27 (14.8%) reported never using HYPO-RT for any of the clinical subsite of HNCs, while the majority (85.2%) used it for glottic cancers and 22% also used it for postoperative setting. Majority (77.7%) used a fractionation schedule with dose per fraction ranging between 2.2 and 2.5 Gy. 6/27 (22.2%) used AFRT for definitive setting and five of these also used concurrent chemoradiotherapy. 4/27 (14.8%) centers reported using HFRT. The most common reason (62.9%) for the limited usage of AFRT/HFRT was reported to be logistical, such as unavailability of machine slots, patient load, and so on.CONCLUSIONThe result of the survey suggests that among the ALFT strategies for HNCs, HYPO-RT schedules have common interest and feasibility among the FARO member countries and also highlights the challenges in the delivery of AFRT/HFRT in the Asian region.https://ascopubs.org/doi/10.1200/GO-24-00349
spellingShingle Ajeet Kumar Gandhi
Supriya Chopra
Madhup Rastogi
Indranil Mallick
Misael C. Cruz
Koichi Yasuda
Ying Ying Sum
Yasushi Nagata
Hong-Gyun Wu
Gregorius B. Prajogi
Henry Kodrat
Mingwei Ma
Asif Nisar
Imjai Chitapanarux
Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
JCO Global Oncology
title Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
title_full Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
title_fullStr Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
title_full_unstemmed Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
title_short Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
title_sort multicentric cross sectional survey to assess the variation of fractionation strategies used in the management of head and neck cancers in the asian region innocence asia
url https://ascopubs.org/doi/10.1200/GO-24-00349
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