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Original Research Article Background: Palliative radiotherapy is an effective option for incurable head and neck cancers. It is delivered by a variety of fractionation schedules. The 'QUAD SHOT' (RTOG 8502) palliative radiotherapy regimen offers an overall high palliative response in patients with locally advanced head and neck cancers.The aim of the present study was comparing the outcome of two versus four weeks gaps between consecutive cycles of radiotherapy in terms of toxicity, compliance, tolerability and loco-regional control, with reduction of overall treatment time. Methodology: Total 100 subjects were treated on cobalt teletherapy machine. This regimen consists of 3.7 Gy twice-daily fractions given over two consecutive days per cycle with a rest period of 2 and 4 weeks between the 3 prescribed cycles for a total dose of 44.4 Gy. Sample size is 50 cases in each group. This study was conducted at Department of Radiation Oncology, S.M.S Medical College Jaipur, and Rajasthan. Results: Overall palliative response is 57% in the study group while 62% in control group which is statistically non significant in both groups. Incidence of acute dermatitis and acute mucositis were higher in study group, it was statistically significant (p=0.034) and (p=0.015) respectively but manageable with supportive measures like intravenous fluid, medication and adequate nutrition. Other radiation reactions were comparable and statistically non-significant (p>0.05) in both treatment arms. Conclusion: On the basis of results it may be conclude that Two weeks gap in 'QUAD SHOT' (RTOG 8502) radiotherapy regimen can be used in locally advanced Head and Neck cancers to shorten overall treatment time without compromising overall palliation achieved in terms of symptomatic response and locoregional control with manageable toxicities.

A Prospective Interventional Study to Compare Two Weeks versus Four Weeks Gap in ‘Quad Shot’ Regimen in Locally Advanced Head and Neck Cancers