Middle East Journal of Cancer

Quad Shot Like Radiotherapy with Concurrent Chemotherapy for Advanced Head and Neck Cancer

Document Type : Original Article(s)

Authors

Poornachandra Tejaswi siddappa 1
Shamsundar Sunkappa 2
Jagannath Kunigal Puttaswamy 2
Nanda Ramanand 2
Aradhana Katke 2
Thejaswini Boraiah 2

1 Department of Radiation Oncology, Karnataka cancer therapy and research institute, Navanagar, Hubli-580025.

2 Department of Radiation Oncology, Kidwai memorial institute of oncology, Hombegowda Nagar, Bengaluru, Karnataka, India-560029.

https://doi.org/10.30476/mejc.2025.104769.2205
Abstract
Background: Improvement in quality of life and palliation of symptoms forms the primary end point in patients unfit for definitive treatment modalities. Quad-shot like radiotherapy aims to achieve these objectives with addition of chemotherapy in advanced head and neck malignancy.
Method: In this study, patients >18 years of age, with advanced head and neck malignancy (stage IVA&B) in non-nasopharyngeal sub-site, not fit for radical treatment were included in this mono-centric, prospective, interventional study. Quad-shot like regimen of 14.4Gray in 4fractions delivered with concurrent carboplatin (AUC2) on day-1 of radiation cycle and reviewed after 3-weeks. Based on palliative response, total two repetition are done. Quality of life analysis was done with European Organization for Research and Treatment– Head & Neck-35 questionnaire Treatment induced toxicity evaluated with common terminology criteria for adverse event version 5.0 and radiation therapy oncology group toxicity grading. Treatment outcome was assessed with response evaluation criteria in solid tumors1.1. Microsoft-excel, SPSS version-22 used to analyze data. Kaplan-Meier survival curves were used for overall survival, P-value<0.05 with Pearson chi-square test and ANOVA was considered as statistically significant.
Results: The palliation of symptoms and improvement in quality of life were recorded in 80% and sustained up to 3 months, with median overall survival of 8±0.411 months, maximum benefit appreciable with larynx compared to other sub-sites. However, grade-4 toxicity reported with one patient in post phase-1 and two patients in post phase-2 and managed with best supportive care.
Conclusion: Quad-shot like radiotherapy with concurrent chemotherapy for advanced head and cancer found to be beneficial in patients unfit for radical treatment resulting in desirable palliative outcome.

Keywords

Radiation Dose Hypofractionation
Carboplatin
Palliative Care
Quality of Life
Squamous Cell Carcinoma of Head and Neck
Subjects

How to cite this article:

Tejaswi-Siddappa P, Sunkappa S, Kunigal-Puttaswamy J, Ramanand N, Katke A, Boraiah T. Quad Shot Like Radiotherapy with Concurrent Chemotherapy for Advanced Head and Neck Cancer. Middle East J Cancer. 2026; 17(1): 55-62. doi: 10.30476/mejc.2025.104769.2205.

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