Concomitant chemoradiation therapy in the Radiation Oncology Unit: can it make a difference?

Background: Concomitant chemoradiation therapy (cCRT) in squamous cell head and neck cancer (SCHNC) patients is associated with high side effects that can lead to unplanned interruption of treatment. In most cases, patients receive chemotherapy in Oncology Unit (OU). The aim of this study is to evaluate how administering cCRT in the same medical unit can impact the quality of treatment. Methods: We retrospectively evaluated the unplanned treatment’s interruption in locally advanced, unresectable, head and neck cancer (HNC) patients who underwent cCRT. Results: From January to December 2022, 33 patients [5 females (F), 28 males (M)] with a median age of 62.5 years underwent cCRT; 48.5% received chemotherapy in a Radiation Oncology Unit (ROU; Group A), 51.5% in an OU (Group B); 8/33 patients received an induction chemotherapy regimen with cisplatin 100 mg q21 or cetuximab. All patients received radiation therapy with a median delivered dose of 66 Gy in 30 fractions (2.2 Gy per fraction using a simultaneous boost); 26/33 (13 Group A and 7 Group B) patients completed cCRT treatment in the expected time (≤49 days). Two Group A patients and 4 Group B interrupted cCRT and completed radiation therapy beyond 49 days. Seven patients did not reach the prescription dose (1 Group A and 6 Group B, respectively). Conclusions: Considering the limitations of a small sample of patients, our analysis highlights how performing cCRT in the same medical unit reduces unplanned interruption and, therefore improves the quality of treatment.