Jennifer Ma1,2, Benjamin H Lok1,3, Jingfeng Zong1,4, Stanley I Gutiontov1,5, Xin Cai1,6, Andrew C Bell1, Marina Shcherba7, Han Xiao7, Eric J Sherman6, Chiaojung Jillian Tsai1, Nadeem Riaz1, Sean M McBride1, Oren Cahlon1,8, Nancy Y Lee1. 1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 2. Albert Einstein College of Medicine, Bronx, NY, USA. 3. Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada. 4. Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China. 5. Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. 6. University of Texas Southwestern Medical Center, Dallas, TX, USA. 7. Department of Medicine, Head and Neck Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 8. Procure Proton Therapy Center, Somerset, NJ, USA.
Abstract
PURPOSE: Some patients with previously treated, unresectable, recurrent or metastatic head and neck malignancies are not amenable to curative-intent treatment. Here, we investigated the quad-shot (RTOG 8502) regimen of hypofractionated proton radiotherapy (RT) in that patient population. MATERIALS AND METHODS: From 2013 to 2015, 26 patients with recurrent or metastatic cancers were treated with palliative proton RT to the head and neck with quad shot (3.7 Gy twice daily for 2 days). Patient characteristics and survival data were reviewed. RESULTS: Seventeen (65%) patients received ≥ 3 quad-shot cycles and 23 (88%) had prior head and neck RT. Overall palliative response was 73% (n = 19). The most common presenting symptom was pain (50%; n = 13), which improved in 85% (n = 22) of all patients. The overall grade-1 acute-toxicity rate was 58% (n = 15), and no acute grade 3 to 5 toxicities were observed. CONCLUSIONS: The proton quad-shot regimen demonstrates favorable palliative response and toxicity profile, even in patients that received prior RT.
PURPOSE: Some patients with previously treated, unresectable, recurrent or metastatic head and neck malignancies are not amenable to curative-intent treatment. Here, we investigated the quad-shot (RTOG 8502) regimen of hypofractionated proton radiotherapy (RT) in that patient population. MATERIALS AND METHODS: From 2013 to 2015, 26 patients with recurrent or metastatic cancers were treated with palliative proton RT to the head and neck with quad shot (3.7 Gy twice daily for 2 days). Patient characteristics and survival data were reviewed. RESULTS: Seventeen (65%) patients received ≥ 3 quad-shot cycles and 23 (88%) had prior head and neck RT. Overall palliative response was 73% (n = 19). The most common presenting symptom was pain (50%; n = 13), which improved in 85% (n = 22) of all patients. The overall grade-1 acute-toxicity rate was 58% (n = 15), and no acute grade 3 to 5 toxicities were observed. CONCLUSIONS: The proton quad-shot regimen demonstrates favorable palliative response and toxicity profile, even in patients that received prior RT.
Entities:
Keywords:
head and neck cancers; palliation; proton therapy; quad shot; radiotherapy
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