Jakhar Shankar Lal, Purohit Ramesh, Solanki Akankhsha, Murali P, Kothari Trupti, Sharma Neeti, Kumar Harvinder Singh
Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College and Associate Group of Hospitals, Bikaner, Rajasthan, India.
J Cancer Res Ther. 2017 Oct-Dec;13(6):943-946. doi: 10.4103/jcrt.JCRT_767_16.
Head and neck cancers are attributed to be the most common type of malignancy in the developing countries with most cases presenting in advanced stage. This pilot study was performed to evaluate the effect of an accelerated hypofractionated 4 days schedule (octa shot) in providing palliation to such advanced cases of head and neck cancer.
Twenty-two patients with advanced (Stage VIB-IVB) squamous cell carcinoma of head and neck region were enrolled in the study. All these patients were planned for radiotherapy at Cobalt Unit with a fractionation schedule of 3.5 Gy/fraction, 2 fractions/day with 6 h interval between two fractions, for four days (28 Gy/8Fr/4 days). Patients were reviewed at 2 and 4 weeks to assess change in tumor size, any symptomatic relief, or toxicity. The tumor response, dermal, and mucosal toxicities were assessed using WHO criteria.
Median age of these 22 patients (17M male + 5F female) in the study was 59.8 years. After completion of radiotherapy, first response evaluation done at 15th day showed ≥50% objective response in 14 patients. At 1 month, this response increased to ≥75% in 16 patients and 50%-75% in three patients. None of the patients had disease progression. Improvement in symptoms was reported with respect to pain and dysphagia by patients subjectively. Only two patients reported Grade III mucositis; remaining patients had mucositis and dermatitis up to Grade II.
The study concludes that this "octa shot" is an effective palliative radiotherapy schedule. With a decreased duration of hospital stay, it is also favorable for outpatients.
头颈癌被认为是发展中国家最常见的恶性肿瘤类型，大多数病例在晚期出现。本前瞻性研究旨在评估加速超分割4天方案（八次照射）对晚期头颈癌患者的姑息治疗效果。
本研究纳入了22例晚期（ⅥB-IVB期）头颈区域鳞状细胞癌患者。所有这些患者计划在钴治疗单元进行放疗，分割方案为3.5 Gy/次，每天2次，两次分割间隔6小时，共4天（28 Gy/8次/4天）。在2周和4周时对患者进行复查，以评估肿瘤大小的变化、任何症状缓解情况或毒性反应。使用世界卫生组织标准评估肿瘤反应、皮肤和黏膜毒性。
本研究中这22例患者（17例男性+5例女性）的中位年龄为59.8岁。放疗完成后，在第15天进行的首次反应评估显示，14例患者有≥50%的客观反应。在1个月时，16例患者的这一反应增加到≥75%，3例患者为50%-75%。没有患者出现疾病进展。患者主观报告疼痛和吞咽困难等症状有所改善。只有2例患者报告有III级黏膜炎；其余患者的黏膜炎和皮炎为II级。
本研究得出结论，这种“八次照射”是一种有效的姑息性放疗方案。由于缩短了住院时间，对门诊患者也有利。
