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Use of split-course hypofractionated radiotherapy in palliative treatment of head and neck cancers: how does our regimen compare with others?

Published online by Cambridge University Press:  09 March 2023

Sankalp Singh
Affiliation:
Radiation Oncology, Command Hospital (CC), Lucknow, India
Niharika Bisht
Affiliation:
Radiation Oncology, Command Hospital (CC), Lucknow, India
Arti Sarin
Affiliation:
Radiation Oncology, INHS Asvini Hospital, Mumbai, India
Rekha Vashisht
Affiliation:
Radiation Oncology, Command Hospital (CC), Lucknow, India
Nishant Lohia*
Affiliation:
Radiation Oncology, Command Hospital (AF), Bangalore, India
Vikas Gupta
Affiliation:
Head and Neck Oncology, Command Hospital (CC), Lucknow, India
Gaurav Trivedi
Affiliation:
Radiation Oncology, Command Hospital (CC), Lucknow, India
*
Author for correspondence: Dr. Nishant Lohia, Radiation Oncology, Command Hospital (AF), Bangalore, India. E-mail: chikslohia@gmail.com

Abstract

Introduction:

Head and neck cancers (HNCs) are some of the commonest cases requiring palliative radiotherapy (PRT) in an Indian radiotherapy practice. A variety of PRT protocols have been explored with varying success.

Methods:

The study objective was to evaluate the efficacy and tolerability of a short-course hypofractionated PRT schedule in HNC patients in terms of symptom relief, tumour response, acute side effects and survival and to compare results with other PRT regimens. All patients received 30 Gy in 10 fractions over 2 weeks followed by another 20 Gy in 5 fractions after a 4 weeks gap.

Results:

Seventy-five percent of patients completed both phases of treatment. Symptom relief was seen in 71% (pain) to 76% (dysphagia) of patients. Tumour response was recorded in 73% of patients. At 12 months, the mean overall survival was 10·29 months for patients who responded to PRT compared to 7·87 months for those who did not. Results were comparable to other regimens reported in the literature, but no radiobiological advantage of a higher dose was discernible.

Conclusions:

Short-course hypofractionated PRT is effective in reducing tumour burden and relieving symptoms in HNC patients and possibly in lengthening survival. Selection of any schedule should be decided by treating oncologists based on clinical, logistic and socio-economic factors.

Type
Original Article
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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