Can Split-Course RT Replace Standard Fractionation in Frail Older HNSCC Patients?
New in The Lancet Healthy Longevity
For decades, radiation oncologists have been delivering hypofractionated split-course radiotherapy to frail older patients with head and neck cancer. Fewer fractions, a mid-course break, less travel. Widely adopted, never tested in a randomised trial.
The ELAN-RT trial changes that. 201 patients, median age 82, 30 centres in France and Monaco.
In this episode: The primary endpoint was met - but the survival data tell a different story. We break down the numbers, discuss why the expected control rate was so far off, and highlight a post-hoc prognostic analysis that identifies which older patients should not be undertreated.
Read the full analysis with data tables
Citation: Ortholan C, Auperin A, Tao Y, et al. Hypofractionated split-course versus standard radiotherapy in frail older patients with head and neck squamous-cell carcinoma (ELAN-RT trial). Lancet Healthy Longev 2026; 7: 100812. doi:10.1016/j.lanhl.2025.100812