Hypofractionated radiotherapy for the palliation of advanced head and neck cancer in patients unsuitable for curative treatment - "Hypo Trial"

被引:107
作者
Porceddu, Sandro V. [1 ,2 ]
Rosser, Brenda [1 ,3 ]
Burmeister, Bryan H. [1 ,2 ]
Jones, Mark [3 ]
Hickey, Brigid [1 ,4 ]
Baumann, Kacy [4 ]
Gogna, Kumar [4 ]
Pullar, Andrew [1 ,4 ]
Poulsen, Michael [2 ,4 ]
Holt, Tanya [4 ]
机构
[1] Princess Alexandra Hosp, So Area Radiat Oncol, Woolloongabba, Qld 4102, Australia
[2] Univ Queensland, Sch Med, St Lucia, Qld 4067, Australia
[3] Univ Queensland, Clin Trials Ctr Queensland, Brisbane, Qld, Australia
[4] Mater Ctr, So Area Radiat, Brisbane, Qld, Australia
关键词
head and neck cancer; radiotherapy; palliation;
D O I
10.1016/j.radonc.2007.10.020
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and purpose: The primary purpose of the trial was to assess rate of tumour response to a hypofractionated course of radiotherapy in patients with incurable squamous cell carcinoma of the head and neck (HNSCC). Secondary objectives included radiation toxicity, symptom control, quality of life (QoL) and progression-free and overall survival. Patients and methods: Patients were planned to receive 30 Gy in 5 fractions at 2/week, at least 3 days apart, with an additional boost of 6 Gy for small volume disease (<=,3 cm) in suitable patients. Thirty-seven patients were enrolled between August 2004 and March 2006. Median age was 68 (43-87) years, 81% were male and the predominant primary site was oropharynx (32%). The majority (73%) presented with Stage III-IV disease. Results: Thirty-five patients received radiotherapy, 1 died prior to treatment and one refused treatment. Of the 35 patients receiving radiotherapy, 31 (88%) received >= 30 Gy. Of the 35 patients who received treatment the overall objective response was 80%. Grade 3 mucositis and dysphagia were experienced in 9/35 (26%) and 4/35 (11%), respectively. QoL and symptom control were assessable in 21 patients. Thirteen (62%) reported an overall improvement in QoL and 14 (67%) experienced an improvement in pain. The median time to progression and death was 3.9 and 6.1 months, respectively. Conclusion: The "Hypo Trial" regimen provided effective palliative treatment in HNSCC unsuitable for curative treatment. Compliance was excellent and resulted in high response rates, symptom control and improvement in QoL with acceptable toxicity. However, progression free and overall survival was short. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:456 / 462
页数:7
相关论文
共 23 条
[1]   POSTOPERATIVE RADIOTHERAPY FOR CUTANEOUS MELANOMA OF THE HEAD AND NECK REGION [J].
ANG, KK ;
PETERS, LJ ;
WEBER, RS ;
MORRISON, WH ;
FRANKENTHALER, RA ;
GARDEN, AS ;
GOEPFERT, H ;
HA, CS ;
BYERS, RM .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1994, 30 (04) :795-798
[2]   DEVELOPMENT OF A EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC) QUESTIONNAIRE MODULE TO BE USED IN QUALITY-OF-LIFE ASSESSMENTS IN HEAD AND NECK-CANCER PATIENTS [J].
BJORDAL, K ;
AHLNERELMQVIST, M ;
TOLLESSON, E ;
JENSEN, AB ;
RAZAVI, D ;
MAHER, EJ ;
KAASA, S .
ACTA ONCOLOGICA, 1994, 33 (08) :879-885
[3]  
Cella D.F., 1997, FACIT MANUAL VERSION
[4]  
CELLA DF, 1996, CANCER, V77, P2294
[5]   The 'QUAD SHOT' - a phase II study of palliative radiotherapy for incurable head and neck cancer [J].
Corry, J ;
Peters, LJ ;
D'Costa, I ;
Milner, AD ;
Fawns, H ;
Rischin, D ;
Porceddu, S .
RADIOTHERAPY AND ONCOLOGY, 2005, 77 (02) :137-142
[6]   TOXICITY CRITERIA OF THE RADIATION-THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC) [J].
COX, JD ;
STETZ, J ;
PAJAK, TF .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (05) :1341-1346
[7]   Squamous cell carcinomas metastatic to cervical lymph nodes from an unknown head and neck mucosal site treated with radiation therapy with palliative intent [J].
Erkal, HS ;
Mendenhall, WM ;
Amdur, RJ ;
Villaret, DB ;
Stringer, SP .
RADIOTHERAPY AND ONCOLOGY, 2001, 59 (03) :319-321
[8]   HYPOFRACTIONATION - LESSONS FROM COMPLICATIONS [J].
FLETCHER, GH .
RADIOTHERAPY AND ONCOLOGY, 1991, 20 (01) :10-15
[9]   BASE OF TONGUE CARCINOMA - PATTERNS OF FAILURE AND PREDICTORS OF RECURRENCE AFTER SURGERY ALONE [J].
FOOTE, RL ;
OLSEN, KD ;
DAVIS, DL ;
BUSKIRK, SJ ;
STANLEY, RJ ;
KUNSELMAN, SJ ;
SCHAID, DJ ;
DESANTO, LW .
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 1993, 15 (04) :300-307
[10]  
HANDA K, 1980, STRAHLENTHER ONKOL, V156, P626