A pilot study on feasibility, toxicity and efficacy of novel hypofractionated radiation therapy in advanced nonnasopharyngeal head and neck carcinoma treated with palliative intent
, 2, 1, 1
Abstract
Introduction: For palliative treatment in patients with advanced inoperable stage IV head and neck cancer
hypofractionated radiotherapy is an efficient, cost-effective option, providing a logistic advantage.
Though there are multiple regimens prescribed, no standard of care has been confirmed. In this study,
a novel hypofractionated regimen has been tested for feasibility and toxicity along with an assessment of
objective treatment response and survival along with self-reported quality of life.
Patients and methods: 30 Patients, having pathologically proven advanced and metastatic non-nasopharyngeal
squamous cell carcinoma of Head and Neck (Stage IV) attending the Radiotherapy Department
of Hospital were allocated to the prescribed hypofractionation regime with 35 Gray in 7 fractions, given
as 2 days a week (total 3.5 weeks). In patients with good response and tolerability, 10 Gray boosts in
2 fractions were given. Patients were followed up at regular intervals for at least 1 year.
Results: The regimen faced a 97% treatment completion rate. Mean time to completion (from first contact)
is 5.8 (95% CI = 5.7–6.0) weeks. The toxicity of this treatment regimen was tolerable with 23.3%
acute and 33.3% incidence of chronic grade 3/4 toxicities. Objective response rate of this study was 66.7%
(p = 0.001) with further 16.7% patients having stable disease. After one month of treatment significant
improvement of quality of life was reported in terms of global health score, functional score and symptoms
score. Mean progression-free survival is 34.4 (95% CI = 27.8–41.1) weeks with 49.4 (95% CI = 44.3–54.5)
weeks of overall survival in 1 year follow up period.
Conclusions: The regimen is well tolerated and is highly feasible and has provided a good response rate
and improved quality of life immediately after treatment along with a better one-year overall survival rate.
Keywords: palliative radiotherapyhypofractionationpilot studyhead and neck cancerquality of lifefeasibility trial
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