title: Palliative Hypo-fractionated Radiotherapy in Locally Advanced Head and Neck Cancer with Fixed Neck Nodes.
abstract: BACKGROUND
  The locally advanced head and neck cancer with fixed nodes are incurable and has a short survival. This study aims to evaluate the symptom relief, disease response and acute toxicity after palliative hypo-fractionated radiotherapy.
  
  
  METHODS
  Between December 2010 to June 2011, previously untreated 50 patients who had histopathologically proved of head and neck squamous cell carcinoma with fixed node of stage IV, Eastern Cooperative Oncology Group (ECOG) performance status 2-3 were offered palliative radiotherapy (20 Gy/5Fr/5 Days). Patients were evaluated at 15th and 30th day after completion of treatment for disease response (WHO), palliation of symptoms using symptomatic response grading and acute toxicities (Radiation Therapy Oncology Group, RTOG).
  
  
  RESULTS
  The most common presenting complaint was pain followed by dysphagia. Majority of patients (60-70%) had appreciable relief in their presenting symptom. In our study, we observed Partial Response (PR) in majority of patients (92 %); no patient had progressive or stable disease. None of the patients experienced radiation toxicities that required hospital admission. Almost all patients showed grade one and two acute skin and mucosal toxicities one month after completion of treatment.
  
  
  CONCLUSIONS
  Advanced head and neck cancer with fixed neck node should be identified for suitable palliative hypo-fractionated radiotherapy to achieve acceptable symptom relief in great proportion of patients.
authors.affiliation: Dept. of Radiatiation Oncology, Acharya tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Paliwal
authors.affiliation: Dept. of Radiatiation Oncology, Acharya tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Kumar-Patidar
authors.affiliation: Dept. of Radiatiation Oncology, Acharya tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Walke
authors.affiliation: Dept. of Radiatiation Oncology, Acharya tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Pushpendra
authors.initials: P
authors.lastname: Hirapara
authors.affiliation: Dept. of Radiatiation Oncology, Acharya tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Jain
authors.affiliation: Dept. of Radiatiation Oncology, Acharya tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
authors.forename: Megh
authors.initials: M
authors.lastname: Raj-Bardia
keywords: Cancer of head and neck; Lymph nodes; Palliative therapy