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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 |
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container_start_page | 20140646 |
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creator | Nguyen, N-T A Doerwald-Munoz, L Zhang, H Kim, D-H Sagar, S Wright, J R 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 |
doi_str_mv | 10.1259/bjr.20140646 |
format | article |
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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 < 0.001), PFS (p < 0.001) and SPFS (p < 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.</description><identifier>ISSN: 0007-1285</identifier><identifier>EISSN: 1748-880X</identifier><identifier>DOI: 10.1259/bjr.20140646</identifier><identifier>PMID: 25694259</identifier><language>eng</language><publisher>England: The British Institute of Radiology</publisher><subject>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</subject><ispartof>British journal of radiology, 2015-05, Vol.88 (1049), p.20140646</ispartof><rights>2015 The Authors. Published by the British Institute of Radiology 2015 The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-240004222bc90b76fc14869b7368e77fcfd11d120cbe789c735cc7c395ad9eb43</citedby><cites>FETCH-LOGICAL-c384t-240004222bc90b76fc14869b7368e77fcfd11d120cbe789c735cc7c395ad9eb43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25694259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, N-T A</creatorcontrib><creatorcontrib>Doerwald-Munoz, L</creatorcontrib><creatorcontrib>Zhang, H</creatorcontrib><creatorcontrib>Kim, D-H</creatorcontrib><creatorcontrib>Sagar, S</creatorcontrib><creatorcontrib>Wright, J R</creatorcontrib><creatorcontrib>Hodson, D I</creatorcontrib><title>0-7-21 hypofractionated palliative radiotherapy: an effective treatment for advanced head and neck cancers</title><title>British journal of radiology</title><addtitle>Br J Radiol</addtitle><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 < 0.001), PFS (p < 0.001) and SPFS (p < 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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Dose Fractionation</subject><subject>Female</subject><subject>Head and neck</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Humans</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Palliative Care</subject><subject>Prognosis</subject><subject>Radiotherapy and Oncology</subject><subject>Radiotherapy Dosage</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0007-1285</issn><issn>1748-880X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNpVUE1LAzEQDaLYWr15lvwAtybZ7CbxIEjxCwpeFLyF7CRxt7a7SzYW-u9N1RY9DTPvYx4PoXNKppQV6qpahCkjlJOSlwdoTAWXmZTk7RCNCSEio0wWI3QyDIvtWihyjEasKBVP4jFakExkjOJ603c-GIhN15roLO7NctmY2KwdDsY2XaxdMP3mGpsWO-8dfEMxOBNXro3YdwEbuzYtJHHtjE1Ei1sHHxi2xzCcoiNvloM7-50T9Hp_9zJ7zObPD0-z23kGueQxYzzl5IyxChSpROmBclmqSuSldEJ48JZSSxmBygmpQOQFgIBcFcYqV_F8gm5-fPvPauUspHTBLHUfmpUJG92ZRv9H2qbW791a85JJLmgyuPwxgNANQ3B-r6VEbzvXqXO96zzRL_7-25N3Jedfoa5_UA</recordid><startdate>20150501</startdate><enddate>20150501</enddate><creator>Nguyen, N-T A</creator><creator>Doerwald-Munoz, L</creator><creator>Zhang, H</creator><creator>Kim, D-H</creator><creator>Sagar, S</creator><creator>Wright, J R</creator><creator>Hodson, D I</creator><general>The British Institute of Radiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20150501</creationdate><title>0-7-21 hypofractionated palliative radiotherapy: an effective treatment for advanced head and neck cancers</title><author>Nguyen, N-T A ; Doerwald-Munoz, L ; Zhang, H ; Kim, D-H ; Sagar, S ; Wright, J R ; Hodson, D I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-240004222bc90b76fc14869b7368e77fcfd11d120cbe789c735cc7c395ad9eb43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Dose Fractionation</topic><topic>Female</topic><topic>Head and neck</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Humans</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Palliative Care</topic><topic>Prognosis</topic><topic>Radiotherapy and Oncology</topic><topic>Radiotherapy Dosage</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, N-T A</creatorcontrib><creatorcontrib>Doerwald-Munoz, L</creatorcontrib><creatorcontrib>Zhang, H</creatorcontrib><creatorcontrib>Kim, D-H</creatorcontrib><creatorcontrib>Sagar, S</creatorcontrib><creatorcontrib>Wright, J R</creatorcontrib><creatorcontrib>Hodson, D I</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, N-T A</au><au>Doerwald-Munoz, L</au><au>Zhang, H</au><au>Kim, D-H</au><au>Sagar, S</au><au>Wright, J R</au><au>Hodson, D I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>0-7-21 hypofractionated palliative radiotherapy: an effective treatment for advanced head and neck cancers</atitle><jtitle>British journal of radiology</jtitle><addtitle>Br J Radiol</addtitle><date>2015-05-01</date><risdate>2015</risdate><volume>88</volume><issue>1049</issue><spage>20140646</spage><pages>20140646-</pages><issn>0007-1285</issn><eissn>1748-880X</eissn><abstract>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 < 0.001), PFS (p < 0.001) and SPFS (p < 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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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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