Impact of stomatitis on pain relief and nutrition in palliative radiotherapy using quad shot: a prospective study
Osamu Tanaka, Kosuke Naganawa, Takashi Matsuzuka, Yuichi Ehara, Yasuhisa Hasegawa, Takuji Kiryu, Akira Ukai, Chiyoko Makita, Masayuki Matsuo

TL;DR
This study shows that Quad Shot radiotherapy reduces tumor pain in head and neck cancer but worsens stomatitis, affecting nutrition and requiring careful management.
Contribution
The study is the first to separately evaluate tumor and stomatitis pain in Quad Shot radiotherapy for head and neck cancer.
Findings
Tumor pain significantly improved with increased Quad Shot treatment duration.
Stomatitis pain worsened significantly after treatment, impacting patients' nutrition as shown by decreased albumin levels.
Quality of life scores remained unchanged, but stomatitis management is critical for maintaining patient well-being.
Abstract
Quad Shot (QS) is effective in treating head and neck cancer; however, few prospective studies have been conducted in this direction. Further, no studies have investigated tumor pain and stomatitis pain separately. We prospectively investigated the efficacy and adverse events of QS in 11 patients with head and neck cancer who underwent QS at our hospital in Japan between 2018 and 2024. The QS method involved administering 3.7 Gy twice daily for 2 days, which was considered one course and provided thrice at an interval of 4 weeks. We assessed quality of life (QOL) scores, albumin levels, and numerical rating scale (NRS) scores for stomatitis and tumor pain before and after QS to evaluate changes in NRS. Eleven patients with advanced head and neck cancer received QS treatment: six patients underwent three courses, three underwent two, and two underwent one. There was no significant…
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Taxonomy
TopicsOral health in cancer treatment · Head and Neck Cancer Studies · Cancer Diagnosis and Treatment
