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Background: Palliative hypofractionated radiotherapy (RT) is an effective mode of treating painful bone metastasis. While 8 Gy single fraction radiation is often effective for the same, for complicated bone metastases a protracted fractionated regimen is preferred, of which 30 Gy/10#/2weeks or 20 Gy/5#/1 week are the most common worldwide. However such schedules add to the burden of already overburdened radiation treatment facilities in a busy center, wherein alternative logistic favourable schedules with treatment on weekends are preferred. Here we compare the efficacy of a twice weekly schedule to that of standard continuous 20 Gy/5 #/1 week schedule in terms of pain relief, response and quality of life., Materials and Methods: A prospective non randomized study was undertaken from Jan 2018 to May 2019, wherein eligible patients of complicated bone metastases received palliative radiotherapy of 20 Gy/5#, either continuously for 5 fractions from Monday to Saturday or twice weekly, Saturday and Wednesday, starting on a Saturday over about 2 weeks. Pain relief was assessed by the Visual Analogue Scale (VAS) and FACES pain scale recorded prior to starting palliative RT and at 4 weeks, 3 months and 6 months., Results: Thirteen patients received continuous Hypofractionated RT while 16 received it in a twice weekly schedule. Spine was the most common site receiving palliative Radiation (27/29), while breast cancer was the most common primary (16/29). The demographic and the baseline characteristics were comparable. The mean pain score decline at 4 weeks was 2.56 ± 1.1 and 2.71 ± 0.52 in the 5-day and the two-week schedule, respectively (p = 0.67)., Conclusion: A twice weekly schedule over about two weeks was found to be equivalent in pain control and response to the standard fractionated palliative radiation and, thus, can be safely employed in resource constrained, busy radiotherapy centers., Competing Interests: Conflict of interest None declared., (© 2023 Greater Poland Cancer Centre.)

Background: Carcinoma of buccal mucosa forms a sizeable percentage of the diagnosed oral cavity cancers in India. There is limited data on elective treatment of the contralateral neck for well-lateralized carcinoma with no involved nodes in the contralateral neck. We conducted this study to compare locoregional control in patients treated with unilateral vs . bilateral neck irradiation., Materials and Methods: 48 patients with carcinoma of buccal mucosa were selected. Patients were divided into unilateral and bilateral arms based on radiation treatment of the ipsilateral or bilateral neck. All patients received adjuvant radiation with Cobalt 60 unit. Patient-specific and follow-up data were collected from records and dosimetric data from treatment planning system (TPS). Chi-square and unpaired t-test was used to compare data between arms and Kaplan Meier plot; Cox regression was used for survival analysis., Results: After a median follow-up of 23 months, 15 (31.3%) patients had developed disease recurrence, 8 and 7 in the unilateral and bilateral arms, respectively (p = 0.591). There was no contralateral neck failure during the follow-up period. The 2-year disease-free survival was 68.2% and 72.2% in the unilateral and bilateral arms, respectively. Among risk factors for disease recurrence, depth of invasion (DOI), delay in starting radiation and planning target volume (PTV) coverage were significant contributing factors. Cox multivariate regression suggested DOI and delay in starting radiation to be significant prognostic factors for disease-free survival (DFS)., Conclusion: Bilateral neck radiation does not provide any advantage over ipsilateral neck radiation for properly selected well lateralized buccal mucosal squamous cell carcinoma. Ipsilateral neck radiation facilitates better sparing of organs at risk., Competing Interests: Conflict of interest No conflict of interest., (© 2022 Greater Poland Cancer Centre.)