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Updated: Feb 4, 2026

Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
Proton Radiotherapy for Recurrent or Metastatic Head and Neck Cancers with Palliative Quad Shot
Jennifer Ma1,2, Benjamin H Lok1,3, Jingfeng Zong1,4
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Purpose:
Some patients with previously treated, unresectable, recurrent or metastatic head and neck malignancies are not amenable to curative-intent treatment. Here, we investigated the quad-shot (RTOG 8502) regimen of hypofractionated proton radiotherapy (RT) in that patient population.
Materials And Methods:
From 2013 to 2015, 26 patients with recurrent or metastatic cancers were treated with palliative proton RT to the head and neck with quad shot (3.7 Gy twice daily for 2 days). Patient characteristics and survival data were reviewed.
Results:
Seventeen (65%) patients received ≥ 3 quad-shot cycles and 23 (88%) had prior head and neck RT. Overall palliative response was 73% (n = 19). The most common presenting symptom was pain (50%; n = 13), which improved in 85% (n = 22) of all patients. The overall grade-1 acute-toxicity rate was 58% (n = 15), and no acute grade 3 to 5 toxicities were observed.
Conclusions:
The proton quad-shot regimen demonstrates favorable palliative response and toxicity profile, even in patients that received prior RT.
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