Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

Abstract

BackgroundThere is little consensus on how best to manage head and neck cancer with palliative intent. Predicting outcome is difficult and reported survival varies. The present study sought to delineate local practice and outcomes in patients treated with palliative intent.MethodsThe clinical records of all head and neck cancer patients treated with palliative intent presenting between 2015 and 2016 to our multidisciplinary team were reviewed.ResultsEighty-four patients (21.5 per cent) were treated with palliative intent. All had squamous cell carcinoma. Mean survival time was 151 days (standard deviation = 121.1; range, 8–536 days). Of the patients, 83.3 per cent had a palliative care referral; 74.1 per cent had a hospice referral. Patients received a variety of interventions, and there was an associated complication in 8.2 per cent. The mean number of days spent in hospital for interventions was 11.9 days (standard deviation = 12.5; range, 0–41 days).ConclusionDifferent interventions are used to manage head and neck cancer patients with palliative intent, and these may be associated with significant morbidity. Survival time is variable, often several months; thus, any treatment must take into account morbidity in conjunction with the patient's wishes.

Hypofractionated palliative volumetric modulated arc radiotherapy with the Radiation Oncology Study Group 8502 “QUAD shot” regimen for incurable head and neck cancer

“…Our results were similar with these results. Considering that the prognosis of patients with HNC who undergo noncurative treatment is poor with approximate survival time of 2-4 months [25,26], palliative RT may contribute to a certin degree of prolonged survival. However, more than half of the patients die within 6 months even if they undergo palliative RT, including RTOG 8502 regimen [4,5,7,8,15,16].…”

Disease trajectories, place and mode of death in people with head and neck cancer: Findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study

“…47,48 In one study, 84/390 (21.5%) people with head and neck cancer were treated with palliative intent following diagnosis. 49 Third, the extent of missing data, especially for the place and mode of death, and the fact that data were recorded by the research team (rather than the clinical team) may limit their accuracy. More robust methods of eliciting this information would be useful within future research.…”

Keep calm and carry on: safety, feasibility and early outcomes of head and neck cancer treatment during the COVID-19 pandemic

“…This is in keeping with previous work in our region pre-COVID-19 which demonstrated that 21% of cases were unsuitable for active anti-cancer treatment, reflecting the significant co-morbidities, poor PS and advanced disease stage we frequently encounter in our cancer network and confirming that patients are not being denied anti-cancer treatment as a result of COVID-19. [40] To date, epidemiological studies have included patients with several different types of cancer and confirmed COVID-19 infection; patients with HNC have made up only a small proportion of these cases. In addition, it is difficult to put the potential risks of COVID-19 infection as a result of HNC treatment into perspective without knowledge of the outcomes of all patients treated during the pandemic.…”