Retrospective Study of Palliative Radiotherapy in Locally Advanced and Metastatic Head and Neck Carcinoma: A Single Institution Study

Introduction The most common cancer of India is head and neck, and about 70% of them present in locally advanced or metastatic disease. Palliative radiotherapy is one of the commonly used treatments in such cases. A retrospective study on the outcomes and toxicity of palliative radiotherapy is studied at a tertiary centre. Materials and Methods In this study, 74 patients who underwent palliative radiotherapy at the tertiary centre between Nov 2017 and Oct 2019 were retrospectively analysed. The frequency of different presenting symptoms, radiotherapy regimens, their outcome in form of symptomatic relief and disease status along with toxicity was studied and analysed through the available records. Results We identified 74 eligible patients. The median age was 48years (range, 26–82). Oropharyngeal primary cancer was the most common primary site. The Eastern Cooperative Oncology Group performance status was 3 or more in 74.4% patients. The radiation regimen used were ranged from 8Gyin single fraction, 20Gy in 4 fractions, 20Gy in 5 fractions, 30Gy in 10 fractions and 60Gy in 30 fractions. 93.2% of them completed their treatment. Pain and swelling were the most common presenting symptoms and 90.6% of them had more than 50% relief, while 46.5% had complete or partial response to the treatment. Conclusion Palliative radiotherapy to the head and neck provides some symptomatic benefit in most patients, there are multiple dose fractionation regimens currently being used for palliative radiation treatment, and consideration should be given to higher dose palliative RT regimens in patients having good performance status to maximize locoregional control and minimize late toxicity, patient with poor performance status will benefit from a hypofractionated palliative radiation treatment.