Intensity-modulated radiotherapy in locally advanced head-and-neck cancers in elderly patients.

Introduction: Head and neck cancer is one of the most common malignancies in Indian males. Due to poor socioeconomic status, presentation is usually in advanced stage. Treatment option is limited to radiotherapy with or without chemotherapy. Intensity-modulated radiotherapy (IMRT) provides highly conformal dose distributions creating nonuniform spatial intensity using different segments in the beam. Concomitant chemoradiation is highly toxic in this age group. Material and Methods: During 2016-2017, 44 patients with locally advanced head-and-neck cancers were treated with a curative intent with IMRT. They were in the age range of 65-75. The median age was 69 years. Thirty five were male and nine were female. Histopathologically, all had squamous cell carcinoma. Stage wise, all were T3N2 or more. The standard technique of IMRT was used with sparing of organs at risk and defining treatment volumes: gross, clinical, and planning. Patients were assessed after 4 weeks of completion of treatment for response and toxicities. Results: Response vise, 14 patients achieved complete response, 28 patients had partial response, and 2 had stable disease. There was no treatment-related mortality. Six patients had treatment interruptions due to toxicity. Incidence of mucositis was of Grade 1-2 in all patients. No hematological toxicity was seen. Patients having dysphagia during treatment were given nasogastric feed.

Incidence of xerostomia in locally advanced head-and-neck cancers in elderly patients treated with intensity-modulated radiotherapy.

Introduction: Dysphagia and xerostomia are the main sequelae of radiotherapy for head and neck cancer (HNC) and the main factors in reducing the longterm patient quality of life. Intensitymodulated radiotherapy (IMRT) uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of noninvolved tissues. Material and Methods: During 2016-2017, 44 patients of locally advanced HNCs were treated with a curative intent with IMRT. They were in the age range of 65-75 years. The median age was 69 years. Thirtyfive patients were male and nine patients were female. Histopathologically, all had squamous cell carcinoma. Stage wise all were T3N2 or more. No concurrent chemotherapy was given. The Eastern Clinical Oncology Group criteria were used for grading the toxicities. Patients were assessed after 4 weeks of completion of treatment. Results and Conclusion: The incidence of mucositis was of Grade 1-2 in 37 patients. Moreover, patients experienced severe mucositis. Six patients had treatment interruptions due to mucositis. Xerostomia was Grade 1-2 in 42 patients and Grade 3 in 2 patients. Dysphagia was Grade 1-2 only. No hematological toxicity was seen. Patients having dysphagia during the treatment were given nasogastric feed. Response wise 14 patients achieved complete response, 28 patients had partial response, and 2 had stable disease. There was no treatmentrelated mortality.