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Comparative Studies | Cancer Science | India | Volume 12 Issue 7, July 2023

A Single Institution Retrospective Study on Palliative Hypofractionated Radiotherapy for Patients with Locally Advanced or Metastatic Head and Neck Cancer with Fixed Neck Nodes

Dr. Anshu Kumar Goel | Dr. Deepika Tripathi

Abstract: Introduction: Head and neck cancer is a prevalent form of cancer in India, with a majority of cases presenting as locally advanced or metastatic disease. Palliative radiotherapy is a frequently used treatment modality for such patients. A retrospective study was conducted at a tertiary center to evaluate the effectiveness and toxicity of palliative radiotherapy in treating advanced head and neck cancer. The study aimed to assess the outcomes and side effects of this treatment approach. Materials and Methods: This retrospective study included 188 patients with locally advanced head and neck squamous cell carcinoma and hard fixed cervical node (s) from January 2012 to December 2014. The patients were treated with external beam radiotherapy using three different fractionation schedules. Treatment response was evaluated based on disease control and symptom palliation using WHO criteria and symptomatic response grading. Acute skin and mucosal reactions grading was done using RTOG toxicity criteria, and further treatment was given based on tumor regression status. Result: The study included 188 patients with head and neck cancer, the majority of whom were male and had T3 stage tumors. The most common symptoms on presentation were pain and swelling. This study investigated the efficacy of three different radiotherapy fractionation schedules (8 Gy in a single fraction, 20 Gy in 5 fractions, and 30 Gy in 10 fractions) in palliative treatment for patients with advanced head and neck cancers. The completion rates for all three schedules were high, with the 30Gy/10# regimen providing the highest pain relief (81.6%), and the 20Gy/5# and 30Gy/10# regimens having a higher rate of partial response and stable disease compared to the 8Gy/1# regimen. The acute toxicity was mild to moderate, with the 8Gy/1# regimen having the lowest incidence of toxicity. Conclusion: The study demonstrated that hypofractionated palliative radiotherapy can be an effective and safe treatment option for patients with locally advanced or metastatic head and neck cancer with fixed neck nodes. The treatment provided significant symptom relief with manageable toxicity. Further studies with larger sample sizes and longer follow - up periods are needed to confirm these findings and determine the optimal patient selection criteria.

Keywords: Head and Neck Cancer, Palliative Care, Radiation Dosage, Palliative radiotherapy, hypofractionation

Edition: Volume 12 Issue 7, July 2023,

Pages: 96 - 100