Palliative Radiation Therapy for Head and Neck Cancers

• Published in: International journal of radiation oncology, biology, physics Vol. 105; no. 2; pp. 254 - 266
• Main Authors: Grewal, Amardeep S., Jones, Joshua, Lin, Alexander
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2019
• Subjects: Cancer Pain - drug therapy; Cancer Pain - radiotherapy; Clinical Trials as Topic; Deglutition Disorders - therapy; Dose Fractionation, Radiation; Episode of Care; Head and Neck Neoplasms - complications; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - radiotherapy; Humans; Immunotherapy - methods; Oropharyngeal Neoplasms - virology; Palliative Care - methods; Papillomavirus Infections - complications; Physical Functional Performance; Prognosis; Proton Therapy; Radiation-Sensitizing Agents - therapeutic use; Radiotherapy - methods; Radiotherapy Dosage; Re-Irradiation; Treatment Outcome; Xerostomia - etiology
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2019.05.024

Patients with advanced head and neck cancers who are not eligible for curative treatment represent a challenging cohort of patients to manage given the complexity and severity of their presenting symptoms. Palliative radiation therapy, along with other systemic and surgical measures, has the potential to significantly improve the quality of life of such patients. There is little high-level evidence and a lack of consensus to direct the selection of an optimal palliative radiation regimen. An ideal palliative radiation regimen should alleviate symptoms secondary to the cancer with minimal treatment toxicity and side effects while improving a patient's quality of life. This review presents the treatment approaches, outcomes, and toxicities associated with different radiation regimens and proposes a multidisciplinary framework for the selection of an individualized treatment regimen for patients that centers around patient prognosis, goals of care, logistics of treatment, and the availability of other surgical and systemic therapies.