Role of hypofractionated palliative radiotherapy in patients with stage four head-and-neck squamous cell carcinoma

Mudgal, Ankur; Arya, Ashok Kumar; Yadav, Indira; Chaudhary, Sandeep

doi:10.4103/jcrt.jcrt_116_18

Cited by 7 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 12 In a similar study in Australia, almost 44% of 25 patients improved their QoL with a quad-shot regimen. 15 Other available choices, such as 30 Gy in five fractions 16 and 40 Gy in 10 fractions, 20 are also effective for improving QoL. However, in our study, on the basis of QoL symptom scores, six (24%) and three (12%) patients exhibited increased symptoms of dry mouth and taste difficulty, respectively.…”

Section: Discussionmentioning

confidence: 55%

“… 19 In contrast to our findings, research conducted in the Netherlands used 50 Gy in 16 fractions for SCC and 45% of patients achieved a CR. This could be because all patients had a considerably greater dosage of radiation with equivalent dose in 2 Gy fractions (EQD2) for tumors about 54.69 Gy 20 compared with our patient's maximal dose with a quad-shot regimen for nine patients, where the EQD2 is 50.69 Gy. In a long retrospective follow-up study, a CR rate of up to 30% was observed with 24 Gy in three fractions.…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Outcome of Hypofractionated Palliative Radiotherapy Regimens for Patients With Advanced Head and Neck Cancer in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study

Zingeta,

Worku,

Awol

et al. 2024

JCO Glob Oncol

View full text Add to dashboard Cite

PURPOSE Head and neck cancers (HNCs) are the third most commonly treated cancer with radiation in Ethiopia. Most patients present with advanced stage and are not candidates for curative treatment. The objective of our study is to assess the outcome of hypofractionated palliative radiotherapy (RT) for advanced HNCs in a resource-limited setting. MATERIALS AND METHODS Patients with histology-proven advanced HNC candidates for hypofractionated palliative RT were enrolled. Three regimens were allowed: 44.4 Gy in 12 fractions, 30 Gy in 10 fractions, and 20 Gy in five fractions. Response to treatment was assessed at baseline and at 4 weeks after treatment completion. The Kaplan-Meier curve was used to measure the survival. RESULTS Between January 2022 and January 2023, 52 patients were enrolled and 25 patients were eligible for outcome assessment. Index symptoms include pain, bleeding, dysphagia, respiratory distress, and others in 25, 13, 10, 6, and 17 patients, respectively. Complete relief of the top three symptoms include pain in 52% of patients, hemostasis in 84% of patients, and dysphagia in 30% of patients. Objectively, 64% of patients attained partial response. For 48% of patients, their quality of life (QoL) improved in one parameter of the physical scores. Moreover, 64% of patients showed improvement in three parameters. The global functional score improved in 80% of patients. One patient had grade 3 xerostomia. At the end of the study period, 44% of patients died. The median survival after radiation was 9 months (95% CI, 7.2 to 10.8) CONCLUSION All palliative hypofractionated regimens used were effective in terms of symptom control, tumor response rate, and QoL, and were well tolerated. This makes it appropriate for our setup because the majority of patients require palliation.

show abstract

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 88%

Outcome of Hypofractionated Palliative Radiotherapy Regimens for Patients With Advanced Head and Neck Cancer in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study

Zingeta,

Worku,

Awol

et al. 2024

JCO Glob Oncol

View full text Add to dashboard Cite

show abstract

“…S1). Two studies were counted twice because they had more than one group using different schedules of palliative RT [40,41]. In the statistical analysis, we considered each group as a single trial, resulting in thirty studies.…”

Section: Resultsmentioning

confidence: 99%

Assessing the efficacy of palliative radiation treatment schemes for locally advanced squamous cell carcinoma of the head and neck: a meta-analysis

Viani

Gouveia

Matsuura

et al. 2023

Rep Pract Oncol Radiother.

View full text Add to dashboard Cite

Background:The objective to assess the outcomes from different palliative radiotherapy (RT) schedules in incurable head and neck cancer (HNC), to evaluate if there is a relationship between RT dose, technique, and fractionation with tumor response in contrast to the occurrence of adverse effects. Materials and methods:Eligible studies were identified on Medline, Embase, the Cochrane Library, and annual meetings proceedings through June 2020. Following PRISMA and MOOSE guidelines, a cumulative meta-analysis of studies for overall response rate (ORR), overall survival (OS), progression-free survival (PFS), pain/dysphagia relief, and toxicity was performed. A meta-regression analysis was done to assess if there is a connection between RT dose, schedule, and technique with ORR. Results:Twenty-eight studies with 1,986 patients treated with palliative RT due to incurable HNC were included. The median OS was 6.5 months [95% confidence interval (CI): 5.6-7.4], and PFS was 3.6 months (95% CI: 2.7-4.3). The ORR, pain and dysphagia relief rates were 72% (95% CI: 0.6-0.8), 83% (95% CI: 52-100%), and 75% (95% CI: 52-100%), respectively. Conventional radiotherapy (2D-RT) or conformational radiotherapy (3D-RT) use were significantly associated with a higher acute toxicity rate (grade ≥ 3) than intensity-modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT). On meta-regression analyses, the total biological effective doses (BED) of RT (p = 0.001), BED > 60 Gy10 (p = 0.001), short course (p = 0.01) and SBRT (p = 0.02) were associated with a superior ORR. Conclusions:Palliative RT achieves tumor response and symptom relief in incurable HNC patients. Short course RT of BED > 60 Gy using IMRT could improve its therapeutic ratio. SBRT should be considered when available.

show abstract

“…At present, radiotherapy is still a critical treatment for cancer therapy, including head, skin, cervical, laryngeal, nasopharyngeal tumors, prostate, and breast cancers ( Cavalieri et al, 2018 ; Mudgal et al, 2019 ). Radiotherapy inhibits tumor growth by generally inducing tumor cell apoptosis, senescence, autophagy, necrosis, or mitotic catastrophe through inflicting extensive DNA damages ( Baskar et al, 2012 ; Chen and Kuo, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Dual Characters of GH-IGF1 Signaling Pathways in Radiotherapy and Post-radiotherapy Repair of Cancers

Cheng

Gui

et al. 2021

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

Radiotherapy remains one of the most important cancer treatment modalities. In the course of radiotherapy for tumor treatment, the incidental irradiation of adjacent tissues could not be completely avoided. DNA damage is one of the main factors of cell death caused by ionizing radiation, including single-strand (SSBs) and double-strand breaks (DSBs). The growth hormone-Insulin-like growth factor 1 (GH-IGF1) axis plays numerous roles in various systems by promoting cell proliferation and inhibiting apoptosis, supporting its effects in inducing the development of multiple cancers. Meanwhile, the GH-IGF1 signaling involved in DNA damage response (DDR) and DNA damage repair determines the radio-resistance of cancer cells subjected to radiotherapy and repair of adjacent tissues damaged by radiotherapy. In the present review, we firstly summarized the studies on GH-IGF1 signaling in the development of cancers. Then we discussed the adverse effect of GH-IGF1 signaling in radiotherapy to cancer cells and the favorable impact of GH-IGF1 signaling on radiation damage repair to adjacent tissues after irradiation. This review further summarized recent advances on research into the molecular mechanism of GH-IGF1 signaling pathway in these effects, expecting to specify the dual characters of GH-IGF1 signaling pathways in radiotherapy and post-radiotherapy repair of cancers, subsequently providing theoretical basis of their roles in increasing radiation sensitivity during cancer radiotherapy and repairing damage after radiotherapy.

show abstract

Role of hypofractionated palliative radiotherapy in patients with stage four head-and-neck squamous cell carcinoma

Cited by 7 publications

References 22 publications

Outcome of Hypofractionated Palliative Radiotherapy Regimens for Patients With Advanced Head and Neck Cancer in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study

Outcome of Hypofractionated Palliative Radiotherapy Regimens for Patients With Advanced Head and Neck Cancer in Tikur Anbessa Hospital, Ethiopia: A Prospective Cohort Study

Assessing the efficacy of palliative radiation treatment schemes for locally advanced squamous cell carcinoma of the head and neck: a meta-analysis

Dual Characters of GH-IGF1 Signaling Pathways in Radiotherapy and Post-radiotherapy Repair of Cancers

Contact Info

Product

Resources

About