Indian Journal of Palliative Care
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 ORIGINAL ARTICLE
Year : 2017  |  Volume : 23  |  Issue : 3  |  Page : 313--316

Hypofractionated radiotherapy for palliation in locally advanced head and neck cancer


1 Department of Radiotherapy, SMS Medical College, Jaipur, Rajasthan, India
2 Linear Accelerator Center, SMS Hospital, Jaipur, Rajasthan, India
3 Department of Radiotherapy, RUHS College of Medical Sciences, Jaipur, Rajasthan, India

Correspondence Address:
R K Spartacus
Department of Radiotherapy, SMS Medical College, Jaipur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPC.IJPC_9_17

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Context: In India, a considerable proportion of patients with head and neck cancer present with locoregionally advanced disease. Symptom palliation becomes a major objective in these cases when they could not be considered for a curative approach. Aims: The aim of this study is to assess the role of palliative radiotherapy for symptom control in patients with locally advanced head and neck cancer. Settings and Design: This was a retrospective study. Subjects and Methods: Between July 2015 and June 2016, 98 patients with stage IV head and neck cancer were treated with palliative radiotherapy 25 Gray (Gy)/4 fractions (fr)/1 fraction (6.25 Gy)/week. Presenting symptoms were noted. The primary end point was relief of symptoms in the 4th week after radiotherapy. Percentage symptom relief was quantified by the patient using a rupee scale. Treatment response was noted using the WHO criteria. Acute toxicity was graded as per the Radiation Therapy Oncology Group (RTOG) criteria. Results: The most common presenting symptom was pain. At 4 weeks after radiotherapy completion, all patients had >50% pain relief. Dysphagia was improved in 82% of patients. Respiratory distress was improved in all the symptomatic patients. Tumor complete response (CR) was seen in 2 patients, partial response in 89, stable disease in 3, and progressive disease in 4. RTOG Grade 2 and 3 acute skin and mucosal toxicities were seen in 29% and 27% cases, respectively. No patient had Grade 4 adverse effect. Conclusions: Hypofractionated radiation could provide effective symptom palliation in advanced head and neck cancers. The weekly schedule was well tolerated and found convenient by the patients.






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