| Article Access Statistics|
| Viewed||3506 |
| Printed||74 |
| Emailed||0 |
| PDF Downloaded||185 |
| Comments ||[Add] |
Click on image for details.
| ORIGINAL ARTICLE
|Year : 2013 | Volume
| Issue : 2 | Page : 93--98
Hypofractionated palliative radiotherapy in locally advanced inoperable head and neck cancer: CMC vellore experience
Saikat Das, Solly Thomas, Suparna Kanti Pal, Rajesh Isiah, Subhashini John
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
Background: A novel, short duration, palliative radiotherapy schedule for inoperable head and neck cancer was evaluated in terms of palliation of cancer-related symptoms and acute toxicities.
Materials and Methods: Thirty-six patients with inoperable head and neck cancer were included in the study (2010-2012). All patients received 40 Gy in 10 fractions (equivalent dose: 49.8 Gy in conventional fractionation) with 2 fractions per week. Treatment-related toxicity was assessed using Radiation Therapy Oncology Group criteria. Functional Assessment of Cancer Therapy (Head and Neck, FACT H and N) quality of life (QOL) tool was administered before starting and at the completion of radiotherapy. Mean value before and after treatment was compared (paired t-test, P = 0.05, two-tailed for significance).
Results: Thirty-three patients (male: 29, female: 4, mean age: 57.8 ± 9.7 years) were included in the analysis (three patients discontinued treatment due to socioeconomic reasons). All patients had advanced inoperable head and neck cancers (27% IVA, 61% IVB, 9% IVC, TNM stage and 3% recurrent disease). Distressing pain at primary site (42%), dysphagia (18%), neck swelling (30%), and hoarseness (10%) were common presentations. Incidence of grade III mucositis and dermatitis and pain was 18%, 3%, and 24%, respectively. Planned radiotherapy without any interruptions was completed by 73% patients. QOL assessment showed improvement in social well-being (17.4 vs. 20.01, P = 0.03), but no significant change was observed in head and neck specific score (25.1 vs. 25.0, P = NS) after treatment. Reduction of pain was observed in 88% patients and 60% patients had improvement of performance status. Median overall survival of the cohort was 7 months.
Conclusions: The study shows that this short duration palliative radiotherapy schedule is a clinically viable option for advanced inoperable head and neck cancer to achieve significant palliation of the main presenting symptoms like pain, dysphagia, and throat pain.
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu
Source of Support: None, Conflict of Interest: None
[FULL TEXT] [PDF]*