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

Head Neck. 2013 Dec;35(12):1683-8. doi: 10.1002/hed.23219. Epub 2013 Jan 29.

Abstract

Background: Standard treatment for unresectable advanced head and neck squamous cell carcinoma is chemoradiotherapy, which can be toxic, particularly among patients with coexisting medical conditions. We report our experience with the hypofractionated radiotherapy regimen Irradiation HypoFractionnée 2 Séances Quotidiennes (IHF2SQ).

Methods: We retrospectively reviewed 78 patients treated with the IHF2SQ regimen. Radiotherapy was administrated as 2 fractions of 3 Gy per day (days 1 and 3), during the first, third, fifth, and seventh week of treatment with concurrent platinum-based chemotherapy.

Results: Tolerance was excellent. Forty-one patients had complete or partial response. Median overall survival (OS) was 12.9 months and median progression-free survival (PFS) was 10.3 months. One-year OS, specific survival (SS), and PFS were 58%, 71%, 51.5%, respectively. Independent predictive factors increasing the PFS were response to chemoradiotherapy, male sex, and laryngeal tumor location.

Conclusions: This regimen is an alternative to conventional chemoradiotherapy with good response rates and acceptable toxicity for selected patients.

Keywords: cetuximab; chemoradiotherapy; head and neck cancer; hypofractionated radiotherapy; palliation.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bridged-Ring Compounds / administration & dosage
  • Carboplatin / administration & dosage
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cetuximab
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Docetaxel
  • Dose Fractionation, Radiation*
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Palliative Care*
  • Radiotherapy / adverse effects
  • Retrospective Studies
  • Sex Factors
  • Taxoids / administration & dosage

Substances

  • Antibodies, Monoclonal, Humanized
  • Bridged-Ring Compounds
  • Taxoids
  • Docetaxel
  • taxane
  • Carboplatin
  • Cetuximab
  • Cisplatin
  • Fluorouracil