Importance of dose in palliative treatment for incurable head and neck cancer with radiotherapy

Purpose: To identify predictors of palliation for head and neck cancer treated with the "Hypo Trial" hypofractionated radiation therapy regimen in a clinical setting.

Design/method: We retrospectively assessed 106 consecutive patients with incurable cancer, treated between January 2008 and December 2018. Regimen used was 30-36Gy in 5-6 biweekly fractions of 6Gy.

Results: The prescription dose was 30Gy in 57 (53.8%) patients and 36Gy in 49 (46.2%) patients. 89.6% patients completed the prescribed treatment. With a median follow-up of 6.92 months, 79.2% of the patients experienced clinical palliation. Palliation was correlated with the radiation therapy dose (P = 0.05). Median overall and progression-free survival (OS, PFS) were 7 and 4.63 months, respectively. Achieving palliation was associated to OS (P = 0.01).

Conclusions: This short palliative hypofractionated scheme resulted in a high rate of palliation, with excellent compliance and acceptable toxicity. Our results show that radiation dose is a predictive factor for palliation.