Palliative RT in HN cancerHypofractionated, palliative radiotherapy for advanced head and neck cancer
Section snippets
Material and methods
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Between January 2000 and June 2005, 110 previously untreated, advanced, unresectable, non-nasopharyngeal head and neck cancer patients formed the study cohort. The eligibility criteria were
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Stage IVB disease, i.e., surgically unresectable due to disease extent (e.g., infratemporal fossa extension, carotid invasion, prevertebral fascia invasion, etc., or fixed/fungating neck nodal masses).
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Stage III or IVA disease with poor performance status.
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No previous history of radiotherapy or chemotherapy.
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Results
The demographic data of 110 patients are shown in Table 1. The common distressing complaints at presentation included pain (109 patients, 99%), dysphagia (97 patients, 88%), neck nodal swelling (95 patients, 86%), and hoarseness (30 patients, 27%). The severity of pain and dysphagia is shown in Table 2. Based on the severity of pain, approximately 80% of the patients required analgesics in the form of either NSAID alone or in combination with opioid or morphine at baseline. Overwhelming
Discussion
In the present study, patients with advanced incurable, non-nasopharyngeal head and neck cancers were treated with 40 Gy in 16 fractions as palliative hypofractionated radiotherapy with selective dose escalation in just over 25% patients up to 50 Gy in 20 fractions. Significant and sustained symptomatic improvement (>75%) was seen in 75 of 86 (87%) patients who had at least 3 months of follow-up. The 1-year progression-free survival of the entire cohort was 55.1%, substantially better than the
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