Department of Radiation Oncology, Lok Nayak Hospital and Associated Maulana Azad Medical College, New Delhi, India.
J Cancer Res Ther. 2021 Jan-Mar;17(1):88-93. doi: 10.4103/jcrt.JCRT_229_20.
Relevance of aggressive treatment in advanced head neck squamous cell cancers(HNSCC) is debatable in view of expected poor outcome. Long treatment duration only adds up to the cost of treatment without any improvements in outcomes.
To assess the outcomes of hypofractionated "Christie" palliative radiotherapy regimen in advanced HNSCC.
Patients of advanced HNSCC registered from June 2015 to June 2019 were treated by parallel pair field technique on Cobalt60 machine (Theatron 780E) to total dose of 50 Gray/16 fractions over 3.2 weeks. Toxicity was scored using Radiation Therapy Oncology Group (RTOG) criteria and response was evaluated as per WHO criteria.
Records of 110 patients of HNSCC with mean age of 56.19 years were analysed. Evaluation at 4-8 weeks after radiotherapy resulted in a complete response (CR) in 19.1%, partial response (PR) in 32.7%, stable disease (SD) in 29.1% and progressive disease (PD) in 3.6%, while 15.5% patients did not report for post treatment evaluation. Median progression free survival was 9.52 months (95% CI 5.9 - 13.1 months). The median overall survival was 12.7 ± 2.2 months (95% CI 8.2 - 17.2). Median time to progression after completion of radiotherapy was 84 days. Grade IV dermatitis and mucositis was encountered in 2.7% and 1.8% cases respectively, requiring hospitalization.
Christie regimen for advanced HNSCC is a clinically viable option with acceptable outcomes in a resource constrained setting.
鉴于预期的不良结果，在晚期头颈部鳞状细胞癌（HNSCC）中进行积极治疗的相关性存在争议。长治疗时间只会增加治疗成本，而不会改善结果。
评估在晚期 HNSCC 中使用低分割“Christie”姑息性放疗方案的结果。
2015 年 6 月至 2019 年 6 月期间，采用平行对置野技术在钴 60 机器（Theatron 780E）上对 110 例晚期 HNSCC 患者进行治疗，总剂量为 50 Gy/16 次，3.2 周内完成。使用放射治疗肿瘤学组（RTOG）标准对毒性进行评分，并根据世界卫生组织（WHO）标准评估反应。
分析了 110 例 HNSCC 患者的记录，平均年龄为 56.19 岁。放疗后 4-8 周评估结果显示完全缓解（CR）为 19.1%，部分缓解（PR）为 32.7%，稳定疾病（SD）为 29.1%，进展疾病（PD）为 3.6%，而 15.5%的患者未进行治疗后评估。无进展生存期的中位数为 9.52 个月（95%CI 5.9-13.1 个月）。总生存期的中位数为 12.7±2.2 个月（95%CI 8.2-17.2 个月）。放疗完成后进展的中位时间为 84 天。四级皮肤和黏膜炎的发生率分别为 2.7%和 1.8%，需要住院治疗。
在资源有限的情况下，Christie 方案治疗晚期 HNSCC 是一种可行的临床选择，具有可接受的疗效。
