Hypofractionated radiotherapy for the palliation of advanced head and neck cancer in patients unsuitable for curative treatment – “Hypo Trial”

Porceddu, Sandro; Rosser, B. R. Simon; Burmeister, Bryan; Jones, Mark; Hickey, Brigid E; Baumann, Kacy; Gogna, Kumar; Pullar, Andrew; Poulsen, Michael; Holt, Tanya

doi:10.1016/j.radonc.2007.10.020

Cited by 128 publications

(129 citation statements)

References 19 publications

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“…The outcomes of such large tumors with nonsurgical treatments are dismal. The reported median survivals in such studies are uniformly under 1 year [21][22][23][24] . The use of induction chemotherapy and assessment for surgery in such tumors seemed a logical option.…”

Section: Borderline Resectable/technically Unresectable Oral Cancersmentioning

confidence: 99%

Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers

et al. 2016

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Locally advanced oral cavity cancers are treated with a multi-modality approach. Surgery is the most efficient local modality in comparison to chemoradiation in oral cancers. Preoperative chemotherapy has failed its expectations to improve disease-free survival or overall survival in resectable oral cancers. Its use as an organ preservation tool is being studied. Induction chemotherapy followed by assessment for surgery is an appropriate option for borderline resectable or technically unresectable oral cancer. Metronomic chemotherapy is being studied as a bridge to surgery and as adjuvant chemotherapy in locally advanced oral cancers. The role of induction chemotherapy in unresectable oral cancers is unproven. Metronomic chemotherapy has shown improved progression-free survival and overall survival in oral cancers in comparison to intravenous cisplatin. A phase 3 study for confirmation of this finding has begun.

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Section: Borderline Resectable/technically Unresectable Oral Cancersmentioning

confidence: 99%

Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers

et al. 2016

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“…Inevitably, treatment interruption due to fatigue or to socioeconomical reasons is frequent in elderly patients [6,35] . Many hypofractionated palliative schedules for HN cancers have been proposed including 20 Gy in five fractions [35] , 30 Gy in five fractions [36] , 14 Gy in four fractions [37] , and 50 Gy in 16 fractions [38] . Nonetheless, increased late toxicity rates were still reported for those patients treated using a hypofractionated schedule [39] .…”

Section: Fractionation and Transportation Issuesmentioning

confidence: 99%

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Mountzios¹

2015

WJCO

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Head and neck cancer (HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients older than 65 years of age at diagnosis is not rare and up to one fourth of cases occurs in patients older that 70 years at age. Because elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary therapeutic approaches. The frailty of elderly patients with HNC is attributed to the high incidence of smoking and alcohol abuse in this malignancy and the presence of substantial cardiovascular, respiratory or metabolic comorbidities. In the current work, I provide an overview of current and emerging treatment approaches, in elderly patients with HNC. In particular, I discuss modern surgical approaches that improve radical excision rates while preserving functionality, the incorporation of modern radiotherapeutic techniques and the introduction of novel chemotherapeutic combinations and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. Finally, there is an urgent need to increase accrual and active participation of elderly patients with HNC in clinical trials, including biomarker evaluation in biopsy specimens towards an individualized therapeutic approach.

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“…In comparison to curative -intent regimens, there are often less data available on optimization of palliative treatment [11,13] . Retrospective, single -institution chart audits with small patient numbers form much of the available literature, with well -known biases [8] .…”

Section: Issues With Interpreting Palliative Radiotherapy Toxicity Datamentioning

confidence: 99%

“…Additionally, not all known and potential sites of disease are necessarily encompassed within a palliative RT fi eld; small, asymptomatic sites may be excluded to decrease toxicity [11] . The use of an effective, but lower, total dose has several advantages: the risk of acute side effects is minimized; RT can be delivered over fewer days; it is more convenient; there is decreased discomfort with positioning and travel; and it frees resources for treatment of other patients [10] .…”

mentioning

confidence: 99%

Side Effects of Palliative Radiotherapy

Fairchild

2013

Radiation Oncology in Palliative Cancer Care

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Hypofractionated radiotherapy for the palliation of advanced head and neck cancer in patients unsuitable for curative treatment – “Hypo Trial”

Cited by 128 publications

References 19 publications

Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers

Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Side Effects of Palliative Radiotherapy

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