Quad Shot: A Short but Effective Schedule for Palliative Radiation for Head and Neck Carcinoma

BACKGROUND: To evaluate a 2-day course of palliative radiation in patients diagnosed to have inoperable or metastatic head and neck carcinoma. AIM: To evaluate the symptom relief and quality of life in these patients after this short course of radiation. SETTINGS AND DESIGN: A pilot study was conducted in a tertiary care institute in India. MATERIALS AND METHODS: Fifteen patients with stage IV B/C disease, KPS 50-70, were inducted after informed consent. External radiation was given in 2 days, two fractions per day, 6 h apart to a total dose of 14 Gy. Washington University quality of life questionnaire (QOL) was used for assessing QOL before and after radiation. Patients who had more than 50% regression of disease received a second course of similar radiation. All patients were followed up for a mean duration of 6 months. STATISTICAL ANALYSIS: The Wilcoxon signed rank test was used to evaluate the difference between the QOL scores before and after treatment. RESULTS AND CONCLUSIONS: Out of these 15 patients, majority (13) were males and the mean age of the patients was 62 years. After the first course, all patients had good symptom relief, improvement in the QOL, and 13 out of 15 had more than 50% objective response. The short duration of the treatment was favored by the outstation patients and their attendants. It may be concluded that this short course of radiation is an effective tool for palliative radiation and merits a larger randomized trial.