Radiother Oncol 2005-11-01
The 'QUAD SHOT'--a phase II study of palliative radiotherapy for incurable head and neck cancer.
ABSTRACT
BACKGROUND AND PURPOSE
The primary objective of this study was to estimate the rate of tumour response to a cyclical hypofractionated palliative radiotherapy regimen (QUAD SHOT) in previously untreated patients with incurable squamous cell carcinoma of the head and neck. Secondary objectives were to prospectively evaluate toxicity, quality of life (QoL) and survival in these patients.
PATIENTS AND METHODS
The QUAD SHOT consisted of 14 Gy in four fractions, given twice a day and at least 6h apart, for 2 consecutive days. This regimen was repeated at 4 weekly intervals for a further two courses if there was no tumour progression. The QoL tool used was an abbreviation of the EORTC QLQ-C30.
RESULTS
Thirty eligible patients (29 Stage IV, 20 performance status 2-3) had at least one treatment and 16 patients completed all three cycles. Sixteen patients (53%) had an objective response (2CR, 14PR) and a further seven had stable disease. Median overall survival was 5.7 months, median progression free survival was 3.1 months. The treatment was very well tolerated, with improved QoL in 11 of 25 evaluable patients (44%).
CONCLUSION
The QUAD SHOT regimen is an effective palliative treatment with minimal toxicity and a good response rate, which impacts positively on patients' QoL.
Related Questions
New comment by Radiation Oncologist at Minneapolis Radiation Oncology ( December 19, 2019)
What do you typically target for the 50Gy/20fx regimen? Just gross disease, or elective nodal regions as well?
Is there a hypofractionated dose regimen that would be suitable for palliation prior to the patient going to hospice?
New answer by Radiation Oncologist at UCSF Medical Center (November 28, 2015)
I also trained at MDA (a lot later ha ha) and I also like the "quad shot" concept. Except I/we do it the way the GYN/RTOG 85-02 palliation trial did it. 370 cGy BID x 2 days, ...
For example, if a patient had severe lung obstruction or hemoptysis from a tumor would it be okay to treat with 3Gy per fraction BID? Or, if a pa...
New answer by Radiation Oncologist at Northeast Alabama Regional Medical Center (January 19, 2017)
Off the cuff re: lung cancer palliation I'd say "yes" it's safe to give 3 gray twice in one day. Because I know it's safe to give 8.5 Gy in one day as part of a 17 Gy palliati...