Quad Shot Palliation, A Considerable Option for Non-Osseous Recurrent or Metastatic Malignancies in Elderly or Frail Patients.

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Saif Ur Rehman
Shafaq Maqsood
Aneela Deevan


Background: Palliative radiation therapy (RT) is increasingly recognized as a crucial component of care for patients with advanced, incurable malignancies. In Pakistan, where patients often present at advanced stages due to socio-economic barriers and limited healthcare access, efficient and effective treatment protocols are essential.

Objective: This study aimed to evaluate the efficacy of the Quad Shot hypo-fractionated RT protocol for pain palliation in elderly and frail patients with recurrent or metastatic non-osseous malignancies.

Methods: A quasi-experimental study was conducted at the Oncology Department of Ganga Ram Hospital, Lahore. Forty-two elderly patients with histologically confirmed inoperable malignancies and a WHO Performance Status of 2 to 3 were enrolled. Patients with prior RT or a second cancer were excluded. RT was delivered using a Cobalt-60 beam, with a total dose of 14 Gy divided into four fractions over two consecutive days. Pain severity was assessed using a 10-point scale before and four weeks after treatment. Statistical analysis was performed using the Wilcoxon Sign Rank Test on SPSS version 25.0.

Results: The study population comprised 52% males and 48% females, with the majority of primary tumors located in the head and neck (64%). Post-treatment, the mean pain score significantly decreased from 8.04 ± 1.22 to 4.32 ± 0.89 (p < 0.05).

Conclusion: The Quad Shot hypo-fractionated RT protocol effectively reduces pain in elderly and frail patients with advanced malignancies, suggesting its suitability as a quick and effective palliative care option in resource-limited settings.

Article Details

How to Cite
Saif Ur Rehman, Shafaq Maqsood, & Aneela Deevan. (2024). Quad Shot Palliation, A Considerable Option for Non-Osseous Recurrent or Metastatic Malignancies in Elderly or Frail Patients. Journal of Health and Rehabilitation Research, 4(2), 456–460. https://doi.org/10.61919/jhrr.v4i2.873
Author Biographies

Saif Ur Rehman, Ganga Ram Hospital Lahore Pakistan

Assistant Professor of Radiotherapy, Ganga Ram Hospital, Lahore, Pakistan

Shafaq Maqsood, Ganga Ram Hospital Lahore Pakistan

Senior Registrar, Oncology Department, Ganga Ram Hospital Lahore Pakistan

Aneela Deevan, Ganga Ram Hospital Lahore Pakistan

Medical Officer, Oncology Department, Ganga Ram Hospital Lahore Pakistan


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