Quad Shot-A Tertiary Hospital Experience With a Palliative Radiotherapy Regimen for Head and Neck Cancer

Head and neck cancer patients often present with locally advanced disease. For some patients, palliative treatment schedules focused on symptom control are often preferred. Perhaps the most widely used of these is the so-called Quad Shot (QS) regimen.

We evaluated 51 patients with head and neck squamous cell carcinomas treated with QS at University Medical Centre Mainz between 2017 and 2024 for response, survival, and toxicity.

Median overall survival was 5.9 (95% CI: 4.3-10.5) months. Thirty-nine patients could be evaluated for response; out of these, 16 patients had an objective response, and 21 patients had stable disease. Only two cases of toxicity Grade 3 or higher were observed and are most likely attributable to other reasons.

QS was well tolerated and showed a meaningful response in most patients. Using real-world data from a highly palliative patient cohort, we discuss several considerations for QS prescription.