What were the patient eligibility criteria, radiation schedules, and outcomes (local‑regional control, overall survival, toxicity) of the RTOG 79‑02 Phase III trial comparing accelerated fractionation to standard fractionation in stage III‑IV head‑and‑neck squamous cell carcinoma?

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RTOG 79-02 Trial Information

I cannot provide specific details about the RTOG 79-02 trial because none of the evidence provided contains information about this particular study. The evidence references multiple other RTOG trials (RTOG 88-09, RTOG 90-03, RTOG 9501, RTOG 0129, RTOG 91-11) but does not include RTOG 79-02.

What the Evidence Does Contain

The provided evidence discusses several relevant RTOG trials in head and neck cancer:

RTOG 88-09 (Phase I/II Trial)

  • Compared two accelerated fractionation variants in Stage III-IV head and neck squamous cell carcinoma 1
  • Split-course accelerated hyperfractionation (AHFX-S): 1.6 Gy twice daily to 67.2 Gy over 6 weeks with 2-week rest after 38.4 Gy 1
  • Concomitant boost accelerated fractionation (AFX-C): 1.8 Gy daily to 54 Gy plus 1.5 Gy boost during last 11 days, total 70.5 Gy over 6 weeks 1
  • 2-year local-regional failure rate was 50%, with survival and disease-free survival of 50% and 40% respectively 1
  • Grade 3 acute toxicity occurred in 63% vs 56% between arms, with permanent grade 4 late toxicity in 6-7% of patients 1

RTOG 90-03 (Phase III Trial)

  • Four-armed trial comparing hyperfractionation and two accelerated fractionation variants versus standard fractionation 2
  • Both accelerated fractionation with concomitant boost (AFX-C) and hyperfractionation showed improved locoregional control and disease-free survival compared with standard fractionation at 2 years 2
  • Long-term follow-up confirmed statistically significant improvement in locoregional control and overall survival with hyperfractionation compared with standard fractionation 2
  • Acute toxicity was increased with accelerated fractionation, but no significant difference in grade 3 or worse late effects at 6-24 months 2

RTOG 9501 (Postoperative Trial)

  • Compared adjuvant radiotherapy alone versus concurrent chemoradiotherapy with cisplatin 100 mg/m² on days 1,22, and 43 2
  • RT dose: 60 Gy in 30 fractions over 6 weeks, with optional 6 Gy boost in 3 fractions to high-risk sites 2
  • High-risk criteria: microscopic tumor at mucosal margins, ≥2 regional lymph nodes involved, or extracapsular extension 2
  • Long-term analysis (median 9.4 years) showed improved outcomes with CRT for high-risk patients with microscopically involved margins and/or extracapsular spread 2

To Obtain RTOG 79-02 Information

You would need to access the original publication or trial registry for RTOG 79-02, as this specific trial is not discussed in the current evidence base provided.

References

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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