Proton Radiotherapy for Recurrent or Metastatic Head and Neck Cancers with Palliative Quad Shot

• Published in: International journal of particle therapy Vol. 4; no. 4; pp. 10 - 19
• Main Authors: Ma, Jennifer, Lok, Benjamin H, Zong, Jingfeng, Gutiontov, Stanley I, Cai, Xin, Bell, Andrew C, Shcherba, Marina, Xiao, Han, Sherman, Eric J, Tsai, Chiaojung Jillian, Riaz, Nadeem, McBride, Sean M, Cahlon, Oren, Lee, Nancy Y
• Format: Journal Article
• Language: English
• Published: United States The Particle Therapy Co-operative Group 01-01-2018
• Subjects: Original; radiotherapy; proton therapy; quad shot; palliation; head and neck cancers
• ISSN: 2331-5180; 2331-5180
• DOI: 10.14338/IJPT-18-00003.1

Some patients with previously treated, unresectable, recurrent or metastatic head and neck malignancies are not amenable to curative-intent treatment. Here, we investigated the quad-shot (RTOG 8502) regimen of hypofractionated proton radiotherapy (RT) in that patient population.
From 2013 to 2015, 26 patients with recurrent or metastatic cancers were treated with palliative proton RT to the head and neck with quad shot (3.7 Gy twice daily for 2 days). Patient characteristics and survival data were reviewed.
Seventeen (65%) patients received ≥ 3 quad-shot cycles and 23 (88%) had prior head and neck RT. Overall palliative response was 73% (n = 19). The most common presenting symptom was pain (50%; n = 13), which improved in 85% (n = 22) of all patients. The overall grade-1 acute-toxicity rate was 58% (n = 15), and no acute grade 3 to 5 toxicities were observed.
The proton quad-shot regimen demonstrates favorable palliative response and toxicity profile, even in patients that received prior RT.