ABSTRACT
Objectives: To determine the efficacy of hypo-fractionated radiotherapy 8 Gray in 1 fraction for palliation of pain secondary to bone metastasis
Study Design: Quasi-experimental study
Place and Duration of Study: Oncology department, Combined Military Hospital, Rawalpindi, Sep 2012 to Nov 2013
Patients and Methods: Forty three patients were included after permission from concerned authorities and Hospital Ethical Committee. OPD registration numbers, name, age, gender, Eastern Cooperative Oncology Group [ECOG] performance status [PS], diagnosis of primary malignancy along with histopathology and sites of skeletal metastasis were recorded. Radiotherapy 8 Gy in 1 fraction was administered using 6MV [mega voltage] Primus Linear Accelerator with 2-2.5 cm margin around the gross disease at the Oncology department, CMH Rawalpindi. Pain score was recorded using visual analogue scale on the day of administering radiotherapy [day 0] and thirty days [day 30] after radiotherapy to assess response to treatment
Results: There was a statistically significant [<0.001] improvement in the scores of pain with treatment at day 30. Thirty four out of forty three patients [86 percent] showed an improvement in pain score
Conclusion: Based on our results hypofractionated radiotherapy 8 Gy in 1fraction is an effective modality in the palliation of pain secondary to bone metastasis
ABSTRACT
Objective: The objective of this study was to determine the efficacy of quad-shot radiation therapy for palliation in locally advanced and metastatic inoperable squamous cell carcinomas of head and neck
Study Design: A quasi-experimental study
Place and Duration of Study: Oncology department, Combined Military Hospital Rawalpindi, from Sep 2012 to Sep 2013
Material and Methods: Thirty five patients were included with histologically confirmed advanced inoperable squamous cell carcinoma in head and neck region, performance status 2 or 3 and survival >/= 3 months. Patients were treated with radiation therapy 14 Gy in four fractions, megavoltage beam, twice daily fractions [at least 6 hours apart], for 2 consecutive days. Symptoms due to cancer [pain and dysphagia] were assessed as per common toxicity criteria adverse event version 4.0 on day 0 before treatment and day 21 after start of treatment
Results: Grades of pain and dysphagia showed significant improvement after treatment with a p-value <0.001. A total of 91.4% patients showed an improvement in grade of pain [32 out of 35 patients] and 45.7% of patients showed improvement in grade of dysphagia [16 out of 35 patients]. There was a statistically significant decrease in grades of pain and dysphagia after treatment
Conclusion: The short duration of hypofractionated radiotherapy with Quad Shot was effective with respect to symptom palliation in locally advanced and metastatic inoperable head and neck cancers
ABSTRACT
To determine the efficacy of whole brain radiotherapy [WBRT] with carboplatin as radiation sensitizer in metastatic brain disease in our adult population. Quasi-experimental study. Department of Oncology, Combined Military Hospital [CMH], Rawalpindi, Pakistan from July 2011 to September 2012. Forty two patients with metastatic brain disease having ECOG performance status [PS] 3 or less with normal hematological and biochemical profile were treated with WBRT with 6MV Photon beam on linear accelerator using parallel opposed lateral beams to a dose of 30 Gys in 10 fractions. Carboplatin was administered in a dose of 150 mg/m2 on day 1 and 6 of WBRT. Improvement in PS and radiological response on CT scan/ MRI brain before and 30 days after the WBRT using response evaluation criteria in solid tumors [RECIST] was evaluated. Out of 42 patients, 38 [90%] showed improvement in PS, 4 [10%] showed either no improvement or worsening of PS [p< 0.001]. Seventeen [41%] patients had complete response, 19 [45%] had partial response, 3 [7%] showed stable disease and 3 [7%] had progressive disease. None of the patients showed grade 3/4 toxicity during treatment. WBRT with carboplatin as radiation sensitizer is effective in palliation of patients with metastatic brain disease