To deal with this problem various accelerated fractionation radiotherapy techniques emerged.
As the area receiving accelerated fractionation RT is very small, there is very little enhancement in acute reactions.
Those with T1-4 N2-3 disease, accrued into the NPC-9901 trial, were irradiated with conventional fractionation and randomized to chemotherapy; those with T3-4 N0-1 disease, accrued into the NPC-9902 trial , were further randomly allocated to radiotherapy with conventional versus accelerated fractionation.
NPC-9902 trial  compared the benefit achieved by CCRT and/or accelerated fractionation (AF) versus RT alone with conventional fractionation (CF) for patients with T34N0-1M0 NPC.
The long-term toxicity of high-dose radiation is often underappreciated, but it is clear that chronic fibrosis, edema, tissue necrosis, and dysphagia are not uncommon and that their incidence increases with more aggressive accelerated fractionation
schemes and with long-term (>5 yr) follow-up.
A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003.
Conventional vs accelerated fractionation in head and neck cancer.
Accelerated fractionation. Accelerated fractionation is a means of decreasing the overall duration of treatment in an effort to reduce the repopulation of tumor cells in rapidly proliferating cancers.
A variant of accelerated fractionation is the concomitant-boost technique.
Newer strategies of hyperfractionation and accelerated fractionation
lead to 7% to 10% improvement in locoregional control compared to once-daily treatment schemes.
RTOG 90-03 was a large randomised trial comparing Standard Fractionation (SFX) against Hyper-Fractionation (HFX), Accelerated Fractionation
with Split-course (AFX-S), and Accelerated Fractionation
by Concomitant Boost (AFXCB) in the management of patients with advanced HNSCC.
Local control improved significantly in this accelerated fractionation