الفهرس 
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Abstract
The incidence of HNSCC is increasing, and it was estimated to be the seventh most common malignant disease worldwide. The most common pattern of treatment failure in HNSCC is the loco-regional failure. Strategies to improve the loco-regional control in HNSCC include combining radiation with sensitizing chemotherapy or radiation dose escalation using altered fractionation. This is a prospective phase I/II single arm study for treatment intensification with altered RT fractionation that included 40 patients with HNSCC presented to clinical oncology and nuclear medicine department of Mansoura University Hospital from January 2012 till September 2013 inclusive, to evaluate acute toxicity, clinical response, tumor control (local, regional and distant), disease free- and overall- survival following treatment with 5-week accelerated radiotherapy schedule (70 Gy/30 fraction, 2.33 Gy per fraction, 6 fractions per week). No grade 4 or 5 acute toxicity was reported. The most common grade 3 acute toxicity was mucositis (57.5%) and dysphagia (45%). The overall grade 3 acute toxicity was 62.5%. Ten to twelve weeks following the RT; Two patients (5%) had SD, four patients (10%) had PR and the remaining 34 patients (85%) showed CR. At a median follow-up of 41 months (range, 6-54), the 3-year local, regional and distant control, disease free- and overall survival were 81.6%, 85.3%, 90.3%, 58.7% and 64.4% respectively.