Literature DB >> 19373698

Hypofractionated radiotherapy denoted as the "Christie scheme": an effective means of palliating patients with head and neck cancers not suitable for curative treatment.

Abrahim Al-mamgani1, Lisa Tans, Peter H E Van rooij, Inge Noever, Robert J Baatenburg de jong, Peter C Levendag.   

Abstract

OBJECTIVES: A prospective study of the efficacy and toxicity profile of patients with squamous cell carcinoma of the head and neck (HNSCC) without curative treatment options treated consistently with hypofractionated radiotherapy schedule. PATIENTS AND METHODS: Between 1995 and 2006, 158 patients with HNSCC, unsuitable for curative treatment, were treated with a hypofractionated scheme of radiotherapy consisting of 16 fractions of 3.125 Gy. Endpoints of the study were response rates, loco-regional control, disease-free survival, overall survival, acute and late toxicity, and quality of life (QoL).
RESULTS: Seventy four percent of patients were male, 31% had oropharyngeal cancer and 81% stage IV disease. With 45% complete response and 28% partial response an overall response rate of 73% was achieved, 6% had stable disease, and 21% progressed during or directly after completion of treatment. Median survival time was 17 months and 62 patients (40%) survived > or =1 year after RT. The actuarial rates of loco-regional control, disease-free survival and overall survival were 62%, 32% and 40% at 1-year, respectively and 32%, 14% and 17% at 3-years, respectively. Acute grade > or =3 skin and mucosal toxicities were observed in 45% and 65% of patients, respectively. Severe late toxicity was reported in 4.5% of patients. Of patients surviving > or =1 year after RT, retrospective chart review showed that 50% gained weight, pain improved in 77%, performance status in 47% and only 29% of them was still feeding-tube dependent.
CONCLUSIONS: Our hypofractionated radiotherapy scheme is an effective, well-tolerated and safe palliative schedule in HNSCC who are unsuitable for curative treatment options. Using 3.125 Gy per fraction (Christie scheme), excellent palliation was achieved resulting in acceptable response rates, excellent symptom control, acceptable toxicity profile, and good QoL of patients surviving > or =1 year after completion of treatment.

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Mesh:

Year:  2009        PMID: 19373698     DOI: 10.1080/02841860902740899

Source DB:  PubMed          Journal:  Acta Oncol        ISSN: 0284-186X            Impact factor:   4.089


  27 in total

Review 1.  Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy.

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Journal:  World J Clin Oncol       Date:  2015-02-10

2.  End-of-life care among head and neck cancer patients.

Authors:  Andrew G Shuman; Ye Yang; Jeremy M G Taylor; Mark E Prince
Journal:  Otolaryngol Head Neck Surg       Date:  2011-05       Impact factor: 3.497

Review 3.  Squamous cell carcinoma of the head and neck in the elderly.

Authors:  Jasenka Gugić; Primož Strojan
Journal:  Rep Pract Oncol Radiother       Date:  2012-08-10

4.  0-7-21 hypofractionated palliative radiotherapy: an effective treatment for advanced head and neck cancers.

Authors:  N-T A Nguyen; L Doerwald-Munoz; H Zhang; D-H Kim; S Sagar; J R Wright; D I Hodson
Journal:  Br J Radiol       Date:  2015-02-19       Impact factor: 3.039

5.  Moderately Hypofractionated Radiotherapy Without Chemotherapy in Elderly or Frail Patients With Head and Neck Cancer.

Authors:  Anneke Fryen; Iris Brandes; Jörn Wichmann; Hans Christiansen; Frank Tavassol; Martin Durisin; Roland Merten
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6.  Palliative head and neck radiotherapy with the RTOG 8502 regimen for incurable primary or metastatic cancers.

Authors:  Benjamin H Lok; Ginger Jiang; Stanley Gutiontov; Ryan M Lanning; Sudeepta Sridhara; Eric J Sherman; Chiaojung Jillian Tsai; Sean M McBride; Nadeem Riaz; Nancy Y Lee
Journal:  Oral Oncol       Date:  2015-08-14       Impact factor: 5.337

7.  End-of-life care pathway of head and neck cancer patients: single-institution experience.

Authors:  T Heinonen; V Loimu; K Saarilahti; T Saarto; A Mäkitie
Journal:  Eur Arch Otorhinolaryngol       Date:  2017-12-15       Impact factor: 2.503

8.  Proton Radiotherapy for Recurrent or Metastatic Head and Neck Cancers with Palliative Quad Shot.

Authors:  Jennifer Ma; Benjamin H Lok; Jingfeng Zong; Stanley I Gutiontov; Xin Cai; Andrew C Bell; Marina Shcherba; Han Xiao; Eric J Sherman; Chiaojung Jillian Tsai; Nadeem Riaz; Sean M McBride; Oren Cahlon; Nancy Y Lee
Journal:  Int J Part Ther       Date:  2018

9.  When Palliative Treatment Achieves More Than Palliation: Instances of Long-term Survival after Palliative Radiotherapy.

Authors:  Madhup Rastogi; Swaroop Revannasiddaiah; Manoj K Gupta; Rajeev K Seam; Priyanka Thakur; Manish Gupta
Journal:  Indian J Palliat Care       Date:  2012-05

10.  Patient-Reported Outcomes Assessing the Impact of Palliative Radiotherapy on Quality of Life and Symptom Burden in Head and Neck Cancer Patients: A Systematic Review.

Authors:  Alexander Fabian; Justus Domschikowski; Markus Hoffmann; Oliver Weiner; Claudia Schmalz; Jürgen Dunst; David Krug
Journal:  Front Oncol       Date:  2021-06-04       Impact factor: 6.244

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