A comparison of radiotherapy or radiochemotherapy with symptomatic treatment alone in patients with advanced head and neck carcinomas

Abstract

The choice of palliative treatment and the prognostic factors in unresectable head and neck cancer cases continue to be controversial. In the present study we compared the survival rates of untreated stage IV head and neck cancer patients with cases managed prospectively at A.C. Camargo Hospital for Cancer with neoadjuvant chemotherapy, concomitant chemotherapy or radiotherapy alone. Previous results had shown that while the type of treatment did not influence survival rates (P = 0.706), tumor response to treatment (whether complete, partial or none) significantly influenced survival (P = 0.00002). In the present study we compared the survival rates in the groups with untreated patients (who remained untreated until death) with the same demographic and clinical characteristics of patients receiving treatment. We found that there was a significant difference between the survival rates of the untreated group and those of the treated groups that was independent of the type of treatment performed (P < 0.00001) or the tumor response to treatment (P < 0.0001).

Hypofractionated palliative radiotherapy in locally advanced inoperable head and neck cancer: CMC vellore experience

“…[11] Response of inoperable locally advanced head and neck cancer to aggressive treatments including chemoradiotherapy is poor and is associated with significant treatment-related toxicities. [12] In India, about 70-75% cases of head and neck cancer present in a locally advanced stage with a significant portion in an inoperable stage. [13] Palliation of distressing presenting symptom like painful ulcer, throat pain, swallowing difficulty, and breathing difficulty is the main objective of treatment,[14] with minimal treatment-related toxicities.…”

“…Instead of increasing the life expectancy, improvement of quality of life and cost benefit issues are more important in our settings. [12] In India, most of the tertiary cancer centers like that of ours are overloaded with patients.…”

Hypofractionated palliative radiotherapy for advanced head and neck cancer: The IHF2SQ regimen

“…Patients with untreated advanced HNSCC have a median survival of approximately 100 days . These patients have been shown to benefit from a locoregional palliative treatment regimen . The optimal palliative radiotherapy schedule is unknown but would provide tumoral response with minimal toxicity.…”

mTHPC‐mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study of 128 patients

“…The median survival for patients with this recurrent disease is 3.9 months. 14 The visibility of these cancers and their impact on routine functions such as chewing and swallowing are a constant reminder of their presence and relentless progression.…”