Split-course hypofractionated radiotherapy for palliation of advanced head and neck squamous cell carcinoma.

Manik Vishal, Devkishen (2015) Split-course hypofractionated radiotherapy for palliation of advanced head and neck squamous cell carcinoma. Masters thesis, Madras Medical College, Chennai.


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A significant proportion of patients with head and neck squamous cell carcinoma (HNSCC) are unsuitable for radical treatment due to factors including tumour stage, performance status (PS) and co-morbidity. Palliative radiotherapy has a useful role in the control of local symptoms. AIM: To assess the local symptom control of advanced HNSCC treated with split course hypofractionated radiotherapy. Additionally, to assess the Quality of Life (QoL); the acute toxicity to the treatment and the immediate loco-regional response. MATERIALS AND METHODS: Thirty patients of very advanced HNSCC with PS of >2 were selected. All the patients after basic work up, were planned to receive initial course of 20Gy radiation (4Gy/ 5 fractions) followed by a two week gap and then re-assessment. All patients with absent or manageable toxicity were further treated with one more course of 20 Gy radiation. Symptom relief was assessed before and after each course of radiation. QoL was assessed using the EORTC QoL questionnaire, before and after radiotherapy. RESULTS: Out of the study population, 70% were males, 50% belonged to age group 61-70 years and all had a PS ≥3. Oropharynx (33.3%) was the commonest site with base of tongue (20%), the commonest subsite. Stage grouping was IVB in 56.67% with 46.67% having a N3 node and dysphagia (43.3%) at presentation. Only 3 patients could not complete the planned courses of RT. Good symptom relief was observed in 73.3%. Improvement in symptom scales was seen, however, functional and global health scores remained low. None had more than Grade 1-2 toxicity from first course. Grade 2 toxicity was seen in majority of patients after second course. Overall response rate was 100% with partial response (PR) in most cases. Median duration of response was 2 months post-treatment. CONCLUSION: Split course hypofractionated palliative RT is feasible in advanced HNSCC and allows for shorter treatment time with acceptable symptom relief.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Split – course; Hypofractionation; Palliation; Advanced HNSCC
Subjects: MEDICAL > Radio Therapy
Depositing User: Punitha K
Date Deposited: 27 Mar 2018 12:06
Last Modified: 27 Mar 2018 12:06
URI: http://repository-tnmgrmu.ac.in/id/eprint/6633

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