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Palliative Radiation Therapy for Advanced Head and Neck Carcinomas: A Phase 2 Study.

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Title: Palliative Radiation Therapy for Advanced Head and Neck Carcinomas: A Phase 2 Study.
Authors: Fortin, Bernard1 bfortin.hmr@ssss.gouv.qc.ca, Khaouam, Nader1, Filion, Edith2, Nguyen-Tan, Phuc Felix2, Bujold, Alexis1, Lambert, Louise2
Source: International Journal of Radiation Oncology, Biology, Physics. Jun2016, Vol. 95 Issue 2, p647-653. 7p.
Subjects: Palliative treatment, Cancer risk factors, Head & neck cancer, Radiotherapy, Quality of life, Toxicity testing, Kaplan-Meier estimator
Abstract: Purpose: Incurable head and neck cancer is hard to manage with usual palliative care. Radiation therapy (RT) in this setting is sometimes omitted because there is an apprehension that the side effects in the head and neck region might counterbalance the benefits. The objective of this phase 2 study was to evaluate whether highly conformal RT could improve the therapeutic ratio with this comprehensive Quality of Life (QOL) and toxicity evaluation.Methods and Materials: Patients from 2 academic centers, deemed unfit for radical treatment because of their poor medical condition or advanced cancer stage by an experienced tumor board, were offered 25 Gy in 5 daily intensity modulated RT fractions over 1 week to the symptomatic tumor volume. QOL was evaluated with the European Organization for Research and Treatment of Cancer QLQ-C15-PAL and QLQ-H&N35 questionnaires, and toxicities with the Common Terminology Criteria for Adverse Events version 4.0. Survival and time to tumor progression were calculated with the Kaplan-Meier method.Results: Thirty-two patients were recruited, of whom 66% had at least T4, N3, or M1 disease. The QOL questionnaires completion rate was 86%. Eighty-eight percent of patients received the planned dose. The median overall survival and progression-free survival times were, respectively, 6.5 and 3.2 months. No grade 4 or 5 toxicity was seen. Only 13% of patients had any grade 3 toxicities, and 17% of patients reported no toxicity at all. The QOL was equal or improved, and head and neck symptoms remained equal to or lower than the baseline values for most patients at up to 6 months. Eighty-five percent of patients would have chosen to receive this RT regimen again when asked.Conclusions: This palliative RT regimen was highly tolerable and effective in preserving or improving self-reported QOL in most patients for up to 6 months, which corresponds to this population's median overall survival. Given the minimal side effects, intensification could be considered to achieve longer locoregional control. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Palliative Radiation Therapy for Advanced Head and Neck Carcinomas: A Phase 2 Study.
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  Data: <searchLink fieldCode="AR" term="%22Fortin%2C+Bernard%22">Fortin, Bernard</searchLink><relatesTo>1</relatesTo><i> bfortin.hmr@ssss.gouv.qc.ca</i><br /><searchLink fieldCode="AR" term="%22Khaouam%2C+Nader%22">Khaouam, Nader</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Filion%2C+Edith%22">Filion, Edith</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Nguyen-Tan%2C+Phuc+Felix%22">Nguyen-Tan, Phuc Felix</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Bujold%2C+Alexis%22">Bujold, Alexis</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Lambert%2C+Louise%22">Lambert, Louise</searchLink><relatesTo>2</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Jun2016, Vol. 95 Issue 2, p647-653. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Palliative+treatment%22">Palliative treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+risk+factors%22">Cancer risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Head+%26+neck+cancer%22">Head & neck cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Radiotherapy%22">Radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Toxicity+testing%22">Toxicity testing</searchLink><br /><searchLink fieldCode="DE" term="%22Kaplan-Meier+estimator%22">Kaplan-Meier estimator</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: <bold>Purpose: </bold>Incurable head and neck cancer is hard to manage with usual palliative care. Radiation therapy (RT) in this setting is sometimes omitted because there is an apprehension that the side effects in the head and neck region might counterbalance the benefits. The objective of this phase 2 study was to evaluate whether highly conformal RT could improve the therapeutic ratio with this comprehensive Quality of Life (QOL) and toxicity evaluation.<bold>Methods and Materials: </bold>Patients from 2 academic centers, deemed unfit for radical treatment because of their poor medical condition or advanced cancer stage by an experienced tumor board, were offered 25 Gy in 5 daily intensity modulated RT fractions over 1 week to the symptomatic tumor volume. QOL was evaluated with the European Organization for Research and Treatment of Cancer QLQ-C15-PAL and QLQ-H&N35 questionnaires, and toxicities with the Common Terminology Criteria for Adverse Events version 4.0. Survival and time to tumor progression were calculated with the Kaplan-Meier method.<bold>Results: </bold>Thirty-two patients were recruited, of whom 66% had at least T4, N3, or M1 disease. The QOL questionnaires completion rate was 86%. Eighty-eight percent of patients received the planned dose. The median overall survival and progression-free survival times were, respectively, 6.5 and 3.2 months. No grade 4 or 5 toxicity was seen. Only 13% of patients had any grade 3 toxicities, and 17% of patients reported no toxicity at all. The QOL was equal or improved, and head and neck symptoms remained equal to or lower than the baseline values for most patients at up to 6 months. Eighty-five percent of patients would have chosen to receive this RT regimen again when asked.<bold>Conclusions: </bold>This palliative RT regimen was highly tolerable and effective in preserving or improving self-reported QOL in most patients for up to 6 months, which corresponds to this population's median overall survival. Given the minimal side effects, intensification could be considered to achieve longer locoregional control. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1016/j.ijrobp.2016.01.039
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      – Code: eng
        Text: English
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        PageCount: 7
        StartPage: 647
    Subjects:
      – SubjectFull: Palliative treatment
        Type: general
      – SubjectFull: Cancer risk factors
        Type: general
      – SubjectFull: Head & neck cancer
        Type: general
      – SubjectFull: Radiotherapy
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      – SubjectFull: Quality of life
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      – SubjectFull: Toxicity testing
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      – SubjectFull: Kaplan-Meier estimator
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    Titles:
      – TitleFull: Palliative Radiation Therapy for Advanced Head and Neck Carcinomas: A Phase 2 Study.
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              M: 06
              Text: Jun2016
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              Y: 2016
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