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• W4385992844 abstract "Objectives: The main objective of this study was to estimate the rate of tumor response with the split course hypofractionated palliative radiotherapy regimen (50 Gy/20 fractions) in previously untreated patients with locally advanced carcinoma of the head and neck. The secondary objective of this study was to prospectively evaluate toxicity and quality of life (QoL) in these patients. Materials and Methods: Between the period of December 2019 and July 2021, in a prospective observational single-arm study, 100 patients of Stage IV squamous cell carcinoma of the head and neck were enrolled. Out of which 55 patients successfully completed split course hypofractionated radiotherapy (50 Gy/20 fractions) in two equally divided phases of 1-week gap with concurrent chemotherapy Cisplatin (35 mg/m2). Response assessment was done using Recist criteria v1.0 and QoL assessment was done using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head & Neck 43. RTOG criteria were used for acute toxicity assessment. Results: Of 100 patients enrolled and planned for the treatment, 68 patients completed the second phase of the hypofractionated schedule after a gap of 1 week without any treatment difficulty. Twenty-five patients were excluded after Phase I completion due to inadequacy of coverage of disease volume in radiation portals. Seven patients expired throughout the course of treatment and eight patients were lost to follow-up. Fifty-five patients were finally analyzed. Overall response rate of 74.5% (1CR+40PR) was observed in the patients (n = 55) evaluated. Primary site disease response was 72.4% and nodal site response was 74.5%. With disease classification as primary bulky and nodal bulky, the disease response was comparable (P > 0.58). Moreover, 100% of patients reported improvement in more than one symptom enhancing the QoL with significant p-values in pain scores (P < 0.00001) and swelling in the neck (P < 0.00001). As defined by RTOG criteria for toxicity assessment, the worst grade toxicity experienced by the maximum number of patients is Grade 1. Grade 1 and 2 mucositis was seen in 76.4%, and Grade 3 and 4 mucositis was seen in 23.6% of patients. Grade 1 and 2 skin reaction was seen in 74.5% and Grade 3 and 4 was seen in 16.4% of patients. No Grade 4 toxicity in relation to Pharyngeal or Laryngeal toxicity was reported. However, these toxicities did not hamper the compliance of the patients. Conclusion: Split-course palliative hypofractionated radiation therapy provides effective palliation of symptoms in locally advanced stages of head and neck cancer. The toxicities are minimal and manageable with comparable outcomes as with other approaches of palliation in these patients. Furthermore, a high tumoricidal dose with acceptable toxicity facilitates better compliance in patients not amenable to curative therapy. Studies suggest that in such scenarios, hypofractionated radiation plays a pivotal role and leads to the exploration of various schedules with different regimes." @default.
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• W4385992844 date "2022-01-01" @default.
• W4385992844 modified "2023-10-14" @default.
• W4385992844 title "High-dose split course hypofractionated radiation: A novel and effective approach in tumor control and palliation in locally advanced head and neck cancer" @default.
• W4385992844 doi "https://doi.org/10.4103/bjoc.bjoc_7_23" @default.
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