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

We report our experience in providing palliative radiotherapy (RT) to patients with head and neck cancers (HNCs). Our hypofractionated regimen, "0-7-21", treats patients with 24 Gy in three fractions. Patients, disease and response data were retrieved for candidates of 0-7-21 from 2005 to...

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Published in:British journal of radiology 2015-05, Vol.88 (1049), p.20140646
Main Authors: Nguyen, N-T A, Doerwald-Munoz, L, Zhang, H, Kim, D-H, Sagar, S, Wright, J R, Hodson, D I
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container_issue 1049
container_start_page 20140646
container_title British journal of radiology
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creator Nguyen, N-T A
Doerwald-Munoz, L
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Hodson, D I
description We report our experience in providing palliative radiotherapy (RT) to patients with head and neck cancers (HNCs). Our hypofractionated regimen, "0-7-21", treats patients with 24 Gy in three fractions. Patients, disease and response data were retrieved for candidates of 0-7-21 from 2005 to 2012. Primary end points included symptom and tumour size responses to RT based on response evaluation criteria in solid tumours (RECIST) guidelines. Secondary end points included progression-free survival (PFS) within the irradiated field, overall survival (OS) and symptomatic PFS (SPFS), calculated using Kaplan-Meier method and adverse events. Cox proportional hazards regression and logistic regression were used to investigate for prognostic factors. A total of 110 patients were included. Among the patients, 40% and 31% had complete response for symptoms and tumour size, respectively; 42% and 50% had partial response for symptoms and tumour size, respectively; and 15% had stability of symptoms and tumour size. Median 6-month OS was 51%, and PFS within the irradiated field was 39%. Planning target volume was predictive of OS (p 
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Planning target volume was predictive of OS (p &lt; 0.001), PFS (p &lt; 0.001) and SPFS (p &lt; 0.005), while higher TNM stage was associated with poorer tumour response (p = 0.02). 0-7-21 is an effective and well-tolerated palliative RT regimen for patients with HNC. There was excellent symptom and local control with acceptable toxicity profile in these patients. This is the first study to describe the outcomes of 0-7-21 in treating advanced HNCs. 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Planning target volume was predictive of OS (p &lt; 0.001), PFS (p &lt; 0.001) and SPFS (p &lt; 0.005), while higher TNM stage was associated with poorer tumour response (p = 0.02). 0-7-21 is an effective and well-tolerated palliative RT regimen for patients with HNC. There was excellent symptom and local control with acceptable toxicity profile in these patients. This is the first study to describe the outcomes of 0-7-21 in treating advanced HNCs. 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Planning target volume was predictive of OS (p &lt; 0.001), PFS (p &lt; 0.001) and SPFS (p &lt; 0.005), while higher TNM stage was associated with poorer tumour response (p = 0.02). 0-7-21 is an effective and well-tolerated palliative RT regimen for patients with HNC. There was excellent symptom and local control with acceptable toxicity profile in these patients. This is the first study to describe the outcomes of 0-7-21 in treating advanced HNCs. The positive results suggest that 0-7-21 provides excellent palliation with minimal toxicity, with significantly less on-treatment time than current published palliative RT regimen.</abstract><cop>England</cop><pub>The British Institute of Radiology</pub><pmid>25694259</pmid><doi>10.1259/bjr.20140646</doi><oa>free_for_read</oa></addata></record>
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source Oxford Journals Online; Alma/SFX Local Collection
subjects Aged
Aged, 80 and over
Dose Fractionation
Female
Head and neck
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - radiotherapy
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Palliative Care
Prognosis
Radiotherapy and Oncology
Radiotherapy Dosage
Retrospective Studies
Survival Rate
Treatment Outcome
title 0-7-21 hypofractionated palliative radiotherapy: an effective treatment for advanced head and neck cancers
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