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Abstrait

Short Course Hypofractionation- Palliative Radiation Regimen in Squamous Cell Carcinoma of Head and Neck

Pramila Kumari

Aim: To evaluate the role of short course hypo-fractionated radiotherapy regimen in patients of locally advanced head and neck cancer(LAHNC)of advanced stage for symptomatic relief.In Indian setting, more than 70% patients present in locally advanced stage and with poor general condition and are suitable candidates for palliative radiotherapy. This is a prospective pilot study of a Regional cancer institute of North west zone. Materials and Methods:36 patients with stage 3 and stage 4, head and neck cancer were treated with a short course of palliative radiotherapy [30 Gray (Gy)] in 10 fractions over 2 weeks). Baseline symptoms were assessed before the start of study for pain, dysphagia, respiratory symptoms, anxiety/depression and dyspnoea. First assessment for symptom relief was done at the completion of radiotherapy and then between 3 to 4 weeks aftercompletion ofradiotherapy. Results: In the present study, out of total 36 patients, 72.22% were males and 27.78% were females and Median Karnofsky score was 60. Most common site was oropharynx in 14 (40%) patients followed by larynx was involved in 9 (24%) patients, hypopharynx was involved in 7 (17%) patients. 11 (31%) patients were found to be in stage III and 25 (69%) patients were found to be in stage IV of carcinoma. After completion of radiotherapy course and 3-4 weeks follow up, 88% patients had pain relief, 83% shown improvement in dysphagia, 81% patients shown improved sleep patterns and 65% improvement in respiratory symptoms. 75% patients had betterment in dysphonia. In 23 (65%) patients, Grade-I Mucositis was seen, 13 (35%) patients shown Grade-II mucositis, 15 (44%) patients had Grade-I skin toxicity and Grade-II skin toxicity was seen in 21 (56%) patients. Conclusion:A short course of radiation promises to effectively relieve symptoms in locally advanced head and neck cancers and reduce the need of ongoing analgesic therapy and hospital visits. It reduces the need of continued supportive care and overall improves quality of patients' life. Reduces patients’ frequent visits to hospital.