ESTRO 2024 - Abstract Book

S1258

Clinical - Head & neck

ESTRO 2024

Keywords: oral cavity cancers, pedicled flap, adjuvant IMRT

1134

Poster Discussion

Search for the ideal palliative fractionation regimen in HNC : a single institutional experience.

Preetha Umesh, Sarthak Tandon, Sandeep Purohit, Parveen Ahlawat, Munish Gairola

Rajiv Gandhi Cancer Institute and Research Centre, Radiation Oncology, New Delhi, India

Purpose/Objective:

Head and Neck Cancers (HNC) comprise of approximately 30% of total cancer burden in the Indian subcontinent, out of which a significantly large population is ineligible for definite treatment due to advanced nature of disease at the time of presentation. However the indications of palliative treatment are not strictly limited to inoperability and metastases but also include logistics in the Indian set up. Owing to large heterogeneity in HNC with respect to different sub-sites, modes of presentation, histologies, patterns of lymphatic dissemination, there is a lack of universal consensus on what should be considered as the ideal palliative fractionation regimen. This study reports a single institutional experience with treating palliative HNC patients with different fractionation schedules in order to evaluate their differences in progression free survival (PFS) and the level of symptomatic relief achieved by these fractionation schedules which have been classified based on their EQD2 (equivalent dose in 2 Gy fractions)

Material/Methods:

Between January 2019 and April 2023, 105 patients of HNC who were treated with palliative radiotherapy were included in this study. Use of chemotherapy in neoadjuvant, concurrent and adjuvant setting was allowed. Appropriate fractionation schedule of palliative radiotherapy for each patient was decided based on indication of palliative treatment, severity of presenting symptom and logistics. Since a wide range of fractionation regimens were practiced, these regimens were classified into two groups. First group, Group A, with fractionations having EQD2 less than 37.5 Gy (20Gy/5#, 25Gy/5#, 30Gy/5# and 30Gy/10#). Second group, Group B, with schedules having EQD2 more than 42.2Gy (40Gy/15# and 50Gy/20#). Based on these two groups patients were then evaluated for PFS and symptomatic relief (if improvement in symptom more than 50% of baseline).

Baseline characteristics grouped according to Group A and Group B have been depicted in Figure 1.