Hypofractionated palliative radiotherapy for advanced head and neck cancer: The IHF2SQ regimen

Monnier, L; Touboul, E.; Durdux, C.; Lang, Philippe; Guily, Jean Lacau St; Huguet, F.

doi:10.1002/hed.23219

Cited by 28 publications

(26 citation statements)

References 20 publications

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“…Other hypofractionated palliative regimens have been reported for head and neck cancers[18-22]. The “Hypo Trial” conducted by Porceddu and colleagues treated 35 incurable head and neck cancer patients with the goal of 30 Gy in 5 fractions with 2 fractions per week.…”

Section: Discussionmentioning

confidence: 99%

“…Overall 80% of patients experienced an overall objective response with Grade 3 mucositis and dysphagia developing in 25% and 11%, respectively[22]. Monnier et al reported on a series of 78 patients treated with a concurrent hypofractionated regimen dubbed the Irradiation HypoFractionnée 2 Séances Quotidiennes (IHF2SQ) that delivered 3Gy twice daily on the first, third, fifth and seventh week of treatment with concurrent platinum-based chemotherapy with a response rate of 54% and 1% of patients developing acute Grade 3 or 4 toxicity[18]. …”

Section: Discussionmentioning

confidence: 99%

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Palliative head and neck radiotherapy with the RTOG 8502 regimen for incurable primary or metastatic cancers

et al. 2015

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Objectives To report on our institutional experience of palliative radiotherapy (RT) of cancers in the head and neck by the RTOG 8502 ‘QUAD SHOT’ regimen. Methods Seventy-five patients completed at least 1 cycle of palliative RT to the head and neck for primary or metastatic disease based on the RTOG 8502 regimen (3.7 Gy twice daily over 2 consecutive days at 4 week intervals per cycle) between 2/2005 and 7/2014. Results Median patient age was 76 years (range 23 to 97). The most common histologies were squamous cell carcinoma (55%), non-anaplastic thyroid carcinoma (10%) and salivary gland carcinoma (9%). Thirty patients (40%) received prior RT at the palliative site. Twenty-eight patients (37%) completed at least three RTOG 8502 cycles. Sixty-five percent of all patients had a palliative response. Median overall survival was 5.67 months (range, 0.20 - 34.5). Grade 3 toxicity in 4 patients (5%) consisted of acute dermatitis and functional mucositis. Palliative response was significantly correlated with increasing number of RTOG 8502 cycles (p=0.012), but not KPS, prior RT, palliative chemotherapy, prior surgery, histology or stage. On survival analysis, palliative response (p<0.001), KPS ≥70 (p=0.001), and greater number of RTOG 8502 cycles (p=0.022) remained independent predictors of improved survival. Conclusions For patients with incurable malignant disease in the head and neck, the palliative RTOG 8502 ‘QUAD SHOT’ regimen provides excellent rates of palliative response with minimal associated toxicity. Patients who are able to complete greater number of RT cycles have higher rates of palliative response and overall survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Palliative head and neck radiotherapy with the RTOG 8502 regimen for incurable primary or metastatic cancers

et al. 2015

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“…A retrospective review from France (Monnier et al.) analyzed patients with incurable head and neck cancer who were treated with palliative chemoradiotherapy between 1997 and 2008 using a special regimen called the IHF2SQ (Irradiation HypoFractionnée 2 Séances Quotidiennes) 5 . These patients received 3 Gy twice a day on days 1 and 3 of the week, during weeks 1, 3, 5, and 7, for a total of 48 Gy, concurrently with chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Role of concurrent chemoradiotherapy and stereotactic body radiation treatment for palliation of previously untreated head and neck cancers

Thomas

Packianathan

Ahmed

et al. 2020

Precision Radiation Oncology

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Palliative concurrent chemoradiotherapy has not been well evaluated for patients who are not a candidate for definitive treatment. Even though stereotactic radiotherapy has established a role in the re‐irradiation of recurrent head and neck tumors, its role is not established as a possible primary treatment modality for patients who are not eligible for curative treatment. This article reviews the available literature on the role of chemoradiotherapy and stereotactic radiation for palliation of previously untreated head and neck cancers.

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“…Other studies [16–19] of hypofractionated, palliative RT with a total dose of 30 to 50 Gy in 5 to 16 fractions for 2 to 5 weeks demonstrated a decent palliative response but with grade 3 acute mucositis rates as high as 18% to 66%. Another study examined the ‘‘IHF2SQ regimen (HypoFractionnée 2 Séances Quotidiennes)’’ of 3 Gy twice a day for 2 fractions, twice a week every other week for weeks 1 to 7 with concurrent, platinum-based chemotherapy for advanced head and neck cancers [20]. The reported grade 3 acute toxicity was only 4%, which is comparable to the 5% observed in our previous photon-based quad shot study with IMRT [5], whereas the median PFS was only 3.8 months [20].…”

Section: Discussionmentioning

confidence: 99%

“…Another study examined the ‘‘IHF2SQ regimen (HypoFractionnée 2 Séances Quotidiennes)’’ of 3 Gy twice a day for 2 fractions, twice a week every other week for weeks 1 to 7 with concurrent, platinum-based chemotherapy for advanced head and neck cancers [20]. The reported grade 3 acute toxicity was only 4%, which is comparable to the 5% observed in our previous photon-based quad shot study with IMRT [5], whereas the median PFS was only 3.8 months [20]. Although acute toxicity evaluation was not standardized in this study, we believe the adverse events observed are representative of patients’ palliative symptom relief.…”

Section: Discussionmentioning

confidence: 99%

Proton Radiotherapy for Recurrent or Metastatic Head and Neck Cancers with Palliative Quad Shot

Lok

Zong

et al. 2018

International Journal of Particle Therapy

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Purpose:Some patients with previously treated, unresectable, recurrent or metastatic head and neck malignancies are not amenable to curative-intent treatment. Here, we investigated the quad-shot (RTOG 8502) regimen of hypofractionated proton radiotherapy (RT) in that patient population.Materials and Methods:From 2013 to 2015, 26 patients with recurrent or metastatic cancers were treated with palliative proton RT to the head and neck with quad shot (3.7 Gy twice daily for 2 days). Patient characteristics and survival data were reviewed.Results:Seventeen (65%) patients received ≥ 3 quad-shot cycles and 23 (88%) had prior head and neck RT. Overall palliative response was 73% (n = 19). The most common presenting symptom was pain (50%; n = 13), which improved in 85% (n = 22) of all patients. The overall grade-1 acute-toxicity rate was 58% (n = 15), and no acute grade 3 to 5 toxicities were observed.Conclusions:The proton quad-shot regimen demonstrates favorable palliative response and toxicity profile, even in patients that received prior RT.

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Hypofractionated palliative radiotherapy for advanced head and neck cancer: The IHF2SQ regimen

Abstract: This regimen is an alternative to conventional chemoradiotherapy with good response rates and acceptable toxicity for selected patients.

Cited by 28 publications

References 20 publications

Palliative head and neck radiotherapy with the RTOG 8502 regimen for incurable primary or metastatic cancers

Palliative head and neck radiotherapy with the RTOG 8502 regimen for incurable primary or metastatic cancers

Role of concurrent chemoradiotherapy and stereotactic body radiation treatment for palliation of previously untreated head and neck cancers

Proton Radiotherapy for Recurrent or Metastatic Head and Neck Cancers with Palliative Quad Shot

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