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cancer, palliative radiotherapy, locally advanced, head neck

Uta Rothschild, Laurent Muller, Axel Lechner, Hans A Schlösser, Dirk Beutner, Heinz Läubli, Alfred Zippelius, Sacha I Rothschild
Head and neck squamous cell carcinoma (HNSCC) is a frequent tumour arising from multiple anatomical subsites in the head and neck region. The treatment for early-stage disease is generally single modality, either surgery or radiotherapy. The treatment for locally advanced tumours is multimodal. For recurrent/metastatic HNSCC palliative chemotherapy is standard of care. The prognosis is limited and novel treatment approaches are urgently needed. HNSCC evades immune responses through multiple resistance mechanisms...
May 14, 2018: Swiss Medical Weekly
Eleonora Farina, Jenny Capuccini, Gabriella Macchia, Luciana Caravatta, Nam P Nguyen, Silvia Cammelli, Giuseppe Zanirato Rambaldi, Savino Cilla, Tigeneh Wondemagegnhu, A F M Kamal Uddin, Mostafà Aziz Sumon, Domenico Genovesi, Milly Buwenge, Francesco Cellini, Vincenzo Valentini, Francesco Deodato, Alessio G Morganti
OBJECTIVES: To evaluate the efficacy and safety of a conformal Short Course Accelerated Radiation therapy (SHARON) for symptomatic palliation of locally advanced or metastatic cancers in older patients. MATERIALS AND METHODS: This is a pooled analysis on patients aged ≥80 years selected between subjects enrolled in 3 phase I-II studies on a short course palliative treatment of advanced or metastatic cancer. The primary endpoint was to evaluate the symptoms response rate produced by accelerated radiotherapy delivered in 4 total fractions in twice a day...
February 1, 2018: Journal of Geriatric Oncology
Muhammad Shahid Iqbal, Charles Kelly, Josef Kovarik, Bojidar Goranov, Ghazia Shaikh, David Morgan, Werner Dobrowsky, Vinidh Paleri
OBJECTIVES: The objective of this systematic review was to identify and appraise the existing evidence of role of palliative radiotherapy for locally advanced non-metastatic head and neck cancer. METHODS: A systematic search of the literature was conducted using Medline, Embase and Cochrane databases and relevant references were included. RESULTS: Literature search revealed a wide variation in dose fractionation regimens. Reported outcomes showed high efficacy and low rate of significant side effects, except in studies utilising higher doses of radiotherapy where higher grade toxicities were seen...
March 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Pierre Decazes, Sébastien Thureau, Bernard Dubray, Pierre Vera
INTRODUCTION: Radiotherapy is a major treatment modality for many cancers. Tumor response after radiotherapy determines the subsequent steps of the patient's management (surveillance, adjuvant or salvage treatment and palliative care). Tumor response assessed during radiotherapy offers a promising opportunity to adapt the treatment plan to reduced / increased target volume, to specifically target sub-volumes with relevant biological characteristics (metabolism, hypoxia, proliferation ...
November 28, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Abhishek Soni, Vivek Kaushal, Monica Verma, Anil Kumar Dhull, Rajeev Atri, Rakesh Dhankhar
BACKGROUND: The aim of the study was to evaluate and compare the efficacy, tolerability and toxicity of three palliative radiotherapy (RT) schedules in locally advanced head and neck carcinoma (LAHNC), i.e. Quad Shot schedule, Christie schedule and conventional palliative schedule. METHODS: The patients were randomly divided into three groups of 30 each. Group I patients were planned for 14.8 Gy in 4 fractions over 2 days, repeated three weekly for two more cycles...
February 2017: World Journal of Oncology
Cristiana Lo Nigro, Nerina Denaro, Anna Merlotti, Marco Merlano
For early-stage head and neck cancer (HNC), surgery (S) or radiotherapy (RT) is a standard treatment. The multidisciplinary approach, which includes multimodality treatment with S followed by RT, with or without chemotherapy (CT) or concurrent chemoradiotherapy (CRT), is required for locally advanced head and neck cancer (LAHNC). CRT improves prognosis, locoregional control (LRC), and organ function in LAHNC, compared to RT alone. Prognosis in recurrent/metastatic HNC (R/M HNC) is dismal. Platinum-based CT, combined with the anti-Epidermal Growth Factor Receptor (EGFR) antibody (Ab) cetuximab, is used in first-line setting, while no further validated options are available at progression...
2017: Cancer Management and Research
R K Spartacus, Rohitashwa Dana, Kartick Rastogi, Aseem Rai Bhatnagar, Dhiraj Daga, Kampra Gupta
CONTEXT: In India, a considerable proportion of patients with head and neck cancer present with locoregionally advanced disease. Symptom palliation becomes a major objective in these cases when they could not be considered for a curative approach. AIMS: The aim of this study is to assess the role of palliative radiotherapy for symptom control in patients with locally advanced head and neck cancer. SETTINGS AND DESIGN: This was a retrospective study...
July 2017: Indian Journal of Palliative Care
Aditya V Shetty, Deborah J Wong
In patients with locally advanced squamous cell cancer of the head and neck, a multimodality treatment approach is recommended. The addition of platinum-based systemic therapy concurrently with radiation has been shown to be superior to radiation alone and is considered standard therapy for locally advanced disease. No study has shown superiority of induction therapy followed by chemoradiotherapy versus chemoradiotherapy alone. In the adjuvant setting only patients with nodal extracapsular extension or positive margins seem to benefit from chemoradiotherapy versus radiotherapy alone...
August 2017: Otolaryngologic Clinics of North America
Rachel Galot, Jean-Pascal Machiels
The treatment of squamous cell carcinoma of the head and the neck depends on the disease's stage. In locally-advanced stage disease, multimodal treatment strategies, including surgery, radiotherapy and chemotherapy, give the best outcome in terms of overall survival. Those treatments are not without negligeable adverse events, which can lead to late debilitating toxicities. In recurrent/metastatic disease, not amenable to surgery or radiation therapy, palliative chemotherapy is the most appropriate treatment...
November 2016: Expert Opinion on Drug Safety
V Murthy, D P Kumar, A Budrukkar, T Gupta, S Ghosh-Laskar, J Agarwal
PURPOSE: The purpose of the following study is to evaluate the efficacy of a twice-weekly hypofractionated palliative radiotherapy schedule in locally very advanced head and neck cancers. MATERIALS AND METHODS: Patients with locally very advanced, head and neck cancers were prospectively evaluated after twice-weekly palliative radiotherapy regimen of 32 Gy in 8 fractions. Median age was 55.5 years and the predominant primary site was oral cavity (46%). Majority (70...
January 2016: Indian Journal of Cancer
Jin-Hua Chen, Yu-Chun Yen, Hsuan-Chia Yang, Shing-Hwa Liu, Sheng-Po Yuan, Li-Li Wu, Fei-Peng Lee, Kuan-Chou Lin, Ming-Tang Lai, Chia-Che Wu, Tsung-Ming Chen, Chia-Lun Chang, Jyh-Ming Chow, Yi-Fang Ding, Szu-Yuan Wu
For locally advanced head and neck squamous cell carcinoma (HNSCC), therapeutic decisions depend on comorbidity or age. We estimated the treatment outcomes of patients with different Charlson comorbidity index (CCI) scores and ages to determine whether aggressive treatment improves survival.Data from the Taiwan National Health Insurance and cancer registry databases were analyzed, and we included >20-year-old patients with American Joint Committee on Cancer (AJCC) stage III or IV HNSCC (International Classification of Diseases, Ninth Revision, Clinical Modification codes 140...
April 2016: Medicine (Baltimore)
Justin Lee, Georges Farha, Ian Poon, Irene Karam, Kevin Higgins, Samuel Pichardo, Kullervo Hynynen, Danny Enepekides
BACKGROUND: Radiotherapy is a critical component of the multidisciplinary management of cancers of the head and neck. It may comprise the primary curative treatment modality or is used in an adjuvant setting to improve local control and survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. Although considerable advances have been made recently in the fields of radiotherapy, systemic treatment and surgery for head and neck tumours, locoregional recurrence rates remain high and treatment side effects may have severe impact on patients' quality of life...
2016: Journal of Therapeutic Ultrasound
Teresa S Finnegan, Neal H Bhatt, Joseph N Shaughnessy, Cesar Perez, Rebecca Redman, Craig Silverman, Jeffrey Bumpous, Kevin Potts, Neal E Dunlap
BACKGROUND: Effective palliation in patients with locally advanced head and neck cancer is important. Cyclical hypofractionated radiotherapy (Quad Shot) is a short-course palliative regimen with good patient compliance, low rates of acute toxicity, and delayed late fibrosis. OBJECTIVE: To review use of the Quad Shot technique at our institution in order to quantify the palliative response in locally advanced head and neck cancer. METHODS: The medical records of 70 patients with head and neck squamous cell carcinoma who had been treated with the Quad Shot technique were analyzed retrospectively (36 had been treated with intensity-modulated radiation therapy and 34 with 3-D conformal radiotherapy)...
January 2016: Journal of Community and Supportive Oncology
Arvind Kumar, Atul Sharma, Bidhu Kalyan Mohanti, Alok Thakar, Nootan Kumar Shukla, Sanjay P Thulkar, Kapil Sikka, Suman Bhasker, Chirom Amit Singh, Sreenivas Vishnubhatla
BACKGROUND: Treatment of unresectable HNSCC is not well defined and has a poor outcome. This study has been designed to address the unmet needs of such groups of patients with primary end points of (a) proportion of patients eligible for radical treatment in each arm (b) loco-regional disease control at 6months between two arms. MATERIALS AND METHODS: Locally advanced and unresectable HNSCC patients (except Nasopharynx and Larynx) unfit for radical treatment were randomized to arm A [short course RT alone (4Gy/#/day for 5days)] or arm B [RT as arm A+concurrent cisplatin at 6mg/m(2)/day IV bolus for 5days]...
October 2015: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Sebastiano Mercadante, Federica Aielli, Claudio Adile, Patrizia Ferrera, Alessandro Valle, Flavio Fusco, Amanda Caruselli, Claudio Cartoni, Pizzuto Massimo, Francesco Masedu, Marco Valenti, Giampiero Porzio
BACKGROUND: Oral symptoms can be a sign of an underlying systemic condition and have a significant impact on quality of life, nutrition, and cost of care, while these lesions are often studied in the context of cancer treatment. However, information regarding oral symptoms in advanced cancer patients is poor. The aim of this multicenter study was to determine the prevalence and the characteristics of oral symptoms in a large population of advanced cancer patients. METHODS: A consecutive sample of patients with advanced cancer for a period of 6 months was prospectively assessed for an observational study...
November 2015: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Nitin Pratap Shishodia, Darshan Devang Divakar, Abdulaziz Abdullah Al Kheraif, Ravikumar Ramakrishnaiah, Akbar Ali Khan Pathan, Narasimha Reddy Parine, Santhosh Vediyera Chandroth, Binu Purushothaman
BACKGROUND: Locally advanced head and neck cancer is generally incurable and has a short survival rate. This study aimed to evaluate symptom relief, disease response, and acute toxicity after palliative hypo-fractionated radiotherapy and long-term survival in affected patients. MATERIALS AND METHODS: Between January 2011 to December 2011, 80 patients who were histopathologically diagnosed as having stage III or stage IV head and neck squamous cell carcinoma based on Eastern Cooperative Oncology Group (ECOG) performance status 1-3, were offered palliative radiotherapy (20 Gy/5Fr/5 Days)...
2015: Asian Pacific Journal of Cancer Prevention: APJCP
N-T A Nguyen, L Doerwald-Munoz, H Zhang, D-H Kim, S Sagar, J R Wright, D I Hodson
OBJECTIVE: We report our experience in providing palliative radiotherapy (RT) to patients with head and neck cancers (HNCs). Our hypofractionated regimen, "0-7-21", treats patients with 24 Gy in three fractions. METHODS: Patients, disease and response data were retrieved for candidates of 0-7-21 from 2005 to 2012. Primary end points included symptom and tumour size responses to RT based on response evaluation criteria in solid tumours (RECIST) guidelines...
May 2015: British Journal of Radiology
Rajan Paliwal, Arvind Kumar-Patidar, Rahul Walke, Pushpendra Hirapara, Sandeep Jain, Megh Raj-Bardia
BACKGROUND: The locally advanced head and neck cancer with fixed nodes are incurable and has a short survival. This study aims to evaluate the symptom relief, disease response and acute toxicity after palliative hypo-fractionated radiotherapy. METHODS: Between December 2010 to June 2011, previously untreated 50 patients who had histopathologically proved of head and neck squamous cell carcinoma with fixed node of stage IV, Eastern Cooperative Oncology Group (ECOG) performance status 2-3 were offered palliative radiotherapy (20 Gy/5Fr/5 Days)...
2012: Iranian Journal of Cancer Prevention
B Jeremic, V Vanderpuye, S Abdel-Wahab, P Gaye, L Kochbati, M Diwani, P Emwula, B Oro, K Lishimpi, J Kigula-Mugambe, D Dawotola, T Wondemagegnehu, C Nyongesa, N Oumar, A El-Omrani, T Shuman, L Langenhoven, L Fourie
AIMS: To investigate patterns of practice in palliative radiotherapy in Africa. MATERIALS AND METHODS: Fifteen centres in Africa provided detailed information about radiotherapy in both metastatic and locally advanced disease via a questionnaire. Information included general information (institution status, equipment, staff, patient number), radiotherapy and other treatment characteristics in bone metastasis, brain metastasis, metastatic spinal cord compression, lung and liver metastasis, as well as locally advanced tumours...
June 2014: Clinical Oncology: a Journal of the Royal College of Radiologists
Kailash Chandra Pandey, Swaroop Revannasiddaiah, Nirdosh Kumar Pant, Vipul Nautiyal, Madhup Rastogi, Manoj Kumar Gupta
CONTEXT: Among patients with locally advanced head and neck squamous cell cancers (LAHNSCC), the prognosis after nonresponse or progression despite induction chemotherapy (IC) is dismal, and further treatment is often palliative in intent. Given that nonresponse to chemotherapy could indicate subsequent radioresistance, we intended to assess the outcomes with two different fractionation schemes. AIMS: To compare the outcomes of two fractionation schemes- 'standard' (consisting 3GyX5 daily fractions for 2 consecutive weeks) versus 'hybrid' (6GyX3 fractions on alternate days during the 1(st) week, followed by 2GyX5 daily fractions in the 2(nd) week)...
September 2013: Indian Journal of Palliative Care
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