COMPARATIVE EVALUATION OF QUALITY OF LIFE IN PATIENTS AFTER TREATMENT WITH THREE PALLIATIVE RADIOTHERAPY SCHEDULES IN ADVANCED HEAD AND NECK CANCER.

Aim & Objectives- To compare the locoregional regression of disease, the incidence of acute toxicity and patient compliance among the 3 hypofractionated radiotherapy regimens. Material & MethodsŸ All patients are given palliative radiotherapy using Varian Linear accelerator using 2D technique in SSG hospital, Vadodara. Ÿ Sample size- 90. Ÿ Patients are randomly divided into 3 groups with each group containing 30 patients. Ÿ One group is given conventional hypofractionated regimen is 30 Gy in 10 fractions, 3 Gy per fraction 5 times a week. Ÿ Second group is given quad shot protocol which delivers 44.4 Gy in 12 fractions, 3.7 Gy per fraction twice a day, with 6 hours interval between 2 fractions for 2 consecutive days and repeated every 3 weekly 3 times. Ÿ The third group is given 36 Gy in 6 fractions, 6 Gy per fraction repeated every weekly for 6 weeks. Ÿ 4 weeks after completion of treatment, patients were assessed for pain relief according to rupee scale. Ÿ Treatment response was assessed using RECIST1.1 criteria. Ÿ Mucositis and skin reaction is graded according to NCI-CTCAE. ResultsŸ Out of the total 90 patients, 69 patients completed the treatment. Ÿ Quad shot protocol was superior to 30 Gy/10# in local response. Ÿ 36 Gy/6# was not inferior to quad shot protocol in local. Ÿ Pain relief was comparable on all three groups without any signicant difference. Ÿ The incidence of mucositis and radiation dermatitis was comparable on all three groups without any signicant difference. Conclusion- 36 Gy in 6 # is recommended as the palliative radiotherapy schedule of choice since it has similar local control and pain relief as quad shot protocol with similar toxicity and it is comfortable for most of the patients.