Abstract
The present status of clinical trial on multiple fractions per day (MFD) for head and neck tumors was reviewed and the problems and utility were discussed. The analysis of several phase I/II studies except a clinical trial of HFX, revealed, 1) significant improvement in local control, 2) statistically significant tendency or borderline significance in most studies concerning survival, 3) more severe acute reaction compared with CF and 4) the same reaction as CF, or weaker in Type A (CHART) concerning late injury. In conclusion, MFD is expected useful to improve the therapeutic ratio, although the effect on survival period is not clear. At present randomized phase III study on Type A is on going in England, also clinical trials including Type B, Type C and CF are on going in the US (RTOG). In the near future we will be able to obtain the final conclusion about the utility of MFD from these phase III trials. Only if the results are coclusive! If not, then there won't be a “final conclusion”!!
