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Palliative split-course hypofractionated radiotherapy for incurable mucosal squamous cell head and neck cancer: a 10 year experience

Published online by Cambridge University Press:  21 September 2015

S. Ponnusamy ,
R. J. Casasola  and
P. G. Niblock
S. Ponnusamy*
Affiliation:
NHS Tayside, Dundee, Angus, UK
R. J. Casasola
Affiliation:
NHS Tayside, Dundee, Angus, UK
P. G. Niblock
Affiliation:
NHS Tayside, Dundee, Angus, UK
*
*Correspondence to: Dr Sangeetha Ponnusamy, NHS Tayside, Dundee, Angus, UK. Tel: 0044 1382 660111. E-mail: sponnusamy@nhs.net
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Abstract

Introduction

Locally advanced head and neck cancer can be a distressing disease due to a variety of reasons. This retrospective study looks at the tolerability and outcomes for palliative split-course hypofractionated radiotherapy for this group of patients treated in our centre.

Results

A total of 59 patients were treated with hypofractionated split-course radiotherapy for incurable mucosal squamous cell carcinoma of the head and neck region in our centre over a 10-year period. In all, 71% had stage IV disease. Radiotherapy consisted of three phases of 14·4 Gy/phase, in four to eight fractions over 4 days giving one·8–3·6 Gy/fraction. The phases were separated by 2 weeks. A total of 40 patients (63%) completed all three phases. A total of 72% patients had no acute toxicities and the palliation rate was 83% (complete and partial). Only five patients had no meaningful palliation having completed all three phases. Median duration of local control was 6 months (range: 1–63 months) and median overall survival was 8 months (range: 1–68 months). In five patients, the control was durable with no recurrence at the time of analysis with survival ranging from 6 to 57 months.

Conclusion

We are the first UK centre to report with long-term data, the use of a palliative three phase regime that provides meaningful palliation with acceptable toxicities. In addition, for some patients, it has resulted in durable long-term control.

Keywords

head and neck cancerhypofractionated radiotherapypalliation
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 1 , March 2016 , pp. 61 - 65
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Copyright
© Cambridge University Press 2015 

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