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Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

  • F D Begbie (a1), C M Douglas (a1), F Finlay (a2) and J Montgomery (a1)

There is little consensus on how best to manage head and neck cancer with palliative intent. Predicting outcome is difficult and reported survival varies. The present study sought to delineate local practice and outcomes in patients treated with palliative intent.


The clinical records of all head and neck cancer patients treated with palliative intent presenting between 2015 and 2016 to our multidisciplinary team were reviewed.


Eighty-four patients (21.5 per cent) were treated with palliative intent. All had squamous cell carcinoma. Mean survival time was 151 days (standard deviation = 121.1; range, 8–536 days). Of the patients, 83.3 per cent had a palliative care referral; 74.1 per cent had a hospice referral. Patients received a variety of interventions, and there was an associated complication in 8.2 per cent. The mean number of days spent in hospital for interventions was 11.9 days (standard deviation = 12.5; range, 0–41 days).


Different interventions are used to manage head and neck cancer patients with palliative intent, and these may be associated with significant morbidity. Survival time is variable, often several months; thus, any treatment must take into account morbidity in conjunction with the patient's wishes.

Corresponding author
Author for correspondence: Mr Finn D Begbie, Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK E-mail:
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Mr F D Begbie takes responsibility for the integrity of the content of the paper

Presented orally at the ENT Scotland Winter Meeting, 10 November 2017, Stirling, Scotland, UK, and as a poster at the Scottish Partnership for Palliative Care Annual Conference, 20 September 2017, Edinburgh, Scotland, UK.

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1Schenker, Y, Arnold, RM, Bauer, JE. An enhanced role for palliative care in the multidisciplinary approach to high-risk head and neck cancer. Cancer 2015;122:340–3
2Irvin, W, Muss, HB, Mayer, DK. Symptom management in metastatic breast cancer. Oncologist 2011;16:1203–14
3Sanford, MT, Greene, KL, Carroll, PR. The argument for palliative care in prostate cancer. Transl Androl Urol 2013;2:278–80
4Siegel, RL, Miller, KD, Jemal, A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:529
5National Institute for Health and Care Excellence. Improving outcomes in head and neck cancers. Cancer service guideline [CSG6]. In: [15 January 2018]
6Kowalski, LP, Carvalho, AL. Natural history of untreated head and neck cancer. Eur J Cancer 2000;36:1032–7
7Cocks, H, Ah-See, K, Capel, M, Taylor, P. Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(suppl 2):198207
8McMahon, JD, Robertson, GA, Liew, C, McManners, J, Mackenzie, FR, Hislop, WS et al. Oral and oropharyngeal cancer in the West of Scotland--long-term outcome data of a prospective audit 1999–2001. Br J Oral Maxillofac Surg. 2011;49:92–8
9Pracy, P, Loughran, S, Good, J, Parmar, S, Goranova, R. Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130(suppl 2):104–10
10Ledeboer, QC, van der Schroeff, MP, Pruyn, JF. Survival of patients with palliative head and neck cancer. Head Neck 2011;33:1021–6
11National Institute for Health and Care Excellence. Sore throat (acute): antimicrobial prescribing. NICE guideline [NG84]. In: [15 February 2018]
12Zeitler, M, Fingland, P, Tikka, T, Douglas, CM, Montgomery, J. Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow. Clin Otolaryngol 2018;43:861–7
13National Records of Scotland. Life Expectancy for Administrative Areas within Scotland 2014–2016. In: [15 February 2018]
14Perri, F, Ionna, F, Pavone, E, Longo, F, Caponigro, F. Treatment approaches in elderly patients with head and neck cancer. Anticancer Agents Med Chem 2013;13:1383–90
15Szturz, P, Vermorken, JB. Treatment of elderly patients with squamous cell carcinoma of the head and neck. Front Oncol 2016;31:199
16Hughley, BB, Sperry, SM, Thomsen, TA, Charlton, ME, Pagedar, NA. Survival outcomes in elderly patients with untreated upper aerodigestive tract cancer. Head Neck 2017;39:215–18
17Young, D, Xiao, CC, Murphy, B, Moore, M, Fakhry, C, Day, TA. Increase in head and neck cancer in younger patients due to human papilloma virus (HPV). Oral Oncol 2015;51:727–30
18Temel, JS, Greer, JA, Muzikansky, A, Gallagher, ER, Admane, S, Jackson, VA et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–42
19Chan, JY, To, VS, Wong, ST, Wei, WI. Quality of dying in head and neck cancer patients: the role of surgical palliation. Eur Arch Otorhinolaryngol 2013;270:681–8
20Paleri, V, Stafford, FW, Sammut, MS. Laser debulking in malignant upper airway obstruction. Head Neck 2005;27:296301
21Davies, E, Linklater, KM, Jack, RH. How is place of death from cancer changing and what affects it? Analysis of cancer registration and service data. Br J Cancer 2006;95:593600
22Scottish Government. Practising Realistic Medicine: Summary. In: [15 January 2019]
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
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