Research Article | DOI: https://doi.org/10.31579/2690-4861/1144
Senior resident, Department of Radiation Oncology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
*Corresponding Author: Shivani Malik, Senior resident, Department of Radiation Oncology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Citation: Shivani Malik, Ashok K. Arya, (2026), Optimizing Palliative Radiotherapy in Incurable Locally Advanced Head and Neck Squamous Cell Cancer [LAHNSCC]: A Prospective Comparison of Quad Shot and a Short Course Hypofractionated Regimen, International Journal of Clinical Case Reports and Reviews, 36(5); DOI:10.31579/2690-4861/1144
Copyright: © 2026, Shivani Malik. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 07 July 2026 | Accepted: 31 July 2026 | Published: 07 August 2026
Keywords: head and neck cancer; palliative radiotherapy; hypofractionation; quad shot; quality of life
Background: Patients with incurable LAHNSCC often require palliative radiotherapy for symptom relief and quality-of-life [QOL]improvement; however, no standard hypofractionated regimen has been universally accepted.
Objectives: The primary objective of the study was to compare clinical response and QOL outcomes between the Quad Shot regimen [ARM A] and a short-course hypofractionated radiotherapy schedule [ARM B] in patients with incurable LAHNSCC following treatment completion and first follow-up assessment. Secondary objectives included comparison of treatment compliance, acute radiation toxicities, performance status improvement, supportive care requirements including Ryle’s tube insertion, feasibility of subsequent palliative systemic therapy, and overall survival between the two treatment arms.
Materials and Methods: This prospective randomized comparative study included 70 patients with histologically confirmed incurable LAHNSCC randomized equally into two arms. Arm A received the (14.8 Gy/4 fractions over 2 days, repeated every 3 weeks for three cycles; total 44.4 Gy). Arm B received 20 Gy/5 fractions over 1 week, repeated after 3 weeks (total 40 Gy).
Results: Treatment completion was higher in Arm A than Arm B (80.0% vs. 71.4%). Partial response was observed in 96.4% and 96.0% of patients, respectively. Both regimens significantly improved Karnofsky Performance Status and quality-of-life scores (p<0.001). Grade 3 mucositis occurred in one patient in Arm A. Median overall survival was 4.0 months in Arm A and 3.5 months in Arm B.
Conclusion: Both regimens achieved effective palliation with acceptable toxicity. The Quad Shot regimen demonstrated better compliance and modest survival benefit, supporting its role in palliative management of incurable LAHNSCC.
Head and neck cancers remain among the most common malignancies worldwide and contribute substantially to cancer-related mortality, particularly in low- and middle-income countries. India carries a disproportionately high disease burden because of widespread tobacco consumption, delayed diagnosis, limited healthcare accessibility, and poor socioeconomic conditions. Squamous cell carcinoma constitutes the predominant histological subtype and frequently presents at an advanced stage with extensive locoregional disease.
Despite progress in surgical techniques, radiotherapy delivery, and systemic therapies, a significant proportion of patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) are not suitable candidates for curative treatment. Advanced age, poor performance status, severe malnutrition, unresectable disease, medical comorbidities, and financial limitations commonly restrict aggressive multimodality management in this population.
For such patients, treatment intent is primarily palliative, focusing on alleviation of distressing symptoms, maintenance of oral intake and speech, preservation of functional independence, and improvement in overall quality of life. Patients with advanced head and neck malignancies frequently experience severe pain, dysphagia, bleeding, fetor, airway compromise, weight loss, and psychosocial impairment, all of which significantly affect daily functioning.
Palliative radiotherapy therefore represents an important component of supportive oncologic care in advanced incurable disease. Hypofractionated schedules are particularly attractive in this setting because they shorten overall treatment duration, reduce repeated hospital visits, improve treatment feasibility in frail individuals, and optimize utilization of limited radiotherapy resources.
Several hypofractionated regimens have demonstrated meaningful symptomatic benefit with acceptable toxicity profiles. Among these, the Quad Shot regimen and short-course schedules such as 20 Gy in 5 fractions are widely practiced in routine clinical settings. Earlier prospective investigations established the feasibility of these approaches, while more recent studies have continued to demonstrate favorable symptom control, quality-of-life improvement, and manageable treatment-related toxicities.
Validated assessment tools including the University of Washington Quality of Life Questionnaire version 4 and Radiation Therapy Oncology Group toxicity criteria are commonly employed to evaluate patient-reported outcomes and acute adverse effects in head and neck cancer patients receiving palliative radiotherapy.
However, an optimal hypofractionated palliative radiotherapy schedule for incurable LAHNSCC has not yet been universally established. Prospective comparative evidence remains limited, particularly from resource-constrained settings and Indian oncology centers. Therefore, the present prospective randomized study was conducted to compare clinical outcomes, treatment tolerability, quality-of-life improvement, and survival between the Quad Shot regimen and a short-course hypofractionated radiotherapy schedule in patients with incurable LAHNSCC.
General Study Details
This prospective randomized comparative study was conducted in the Department of Radiation Oncology at a tertiary care teaching institute in India between February 2024 and December 2025. The study was designed as an open-label parallel-arm trial comparing two hypofractionated palliative radiotherapy schedules in patients with incurable locally advanced head and neck squamous cell carcinoma (LAHNSCC).
The study protocol was approved by the Institutional Ethics Committee (IEC approval number: SNMC/IEC/2024/195; dated 2 February 2024). Written informed consent was obtained from all participants before enrolment. The study adhered to the ethical principles of the Declaration of Helsinki, Good Clinical Practice guidelines, and Indian Council of Medical Research ethical recommendations.
The primary objective of the study was to compare clinical response and quality-of-life outcomes between the Quad Shot regimen and a short-course hypofractionated radiotherapy schedule in patients with incurable LAHNSCC following treatment completion and first follow-up assessment.
Secondary objectives included comparison of treatment compliance, acute radiation toxicities, performance status improvement, supportive care requirements including Ryle’s tube insertion, feasibility of subsequent palliative systemic therapy, and overall survival between the two treatment arms.
Study Methodology
A total of 70 treatment-naïve patients with histopathologically confirmed LAHNSCC were enrolled during the study period. Patients attending the Radiation Oncology outpatient department who fulfilled the eligibility criteria were consecutively screened for inclusion.
Patients aged ≥18 years with unresectable stage IVA or IVB squamous cell carcinoma of the head and neck region who were unsuitable for curative treatment were eligible for enrolment. Additional inclusion criteria included Karnofsky Performance Status (KPS) >40, adequate hematological and biochemical parameters, and ability to provide informed consent.
Patients with distant metastases, prior surgery, chemotherapy or radiotherapy for head and neck malignancy, non-squamous histology, synchronous malignancy, uncontrolled comorbid illness, pregnancy, or inability to comply with treatment or follow-up were excluded.
Baseline demographic details, addiction history, tumor site, disease stage, nutritional status, and performance status were documented before treatment initiation.
Randomization and Allocation
Eligible patients were randomized in a 1:1 ratio into two treatment groups using computer-generated random numbers. Allocation concealment was ensured using sequentially numbered opaque sealed envelopes prepared before study initiation, which were opened only after patient enrolment.
Blinding was not feasible because of the nature of the intervention. However, predefined response criteria, standardized toxicity grading systems, uniform treatment protocols, and scheduled follow-up assessments were used to reduce observer-related bias.
Arm A: Quad Shot Regimen
Patients allocated to Arm A received hypofractionated radiotherapy to a total dose of 14.8 Gy delivered in 4 fractions of 3.7 Gy over 2 consecutive days, with two fractions administered daily at a minimum interval of 6 hours. The cycle was repeated every 3 weeks for a maximum of three cycles in the absence of disease progression or unacceptable toxicity, resulting in a planned cumulative dose of 44.4 Gy in 12 fractions.
Arm B: Short-Course Hypofractionated Regimen
Patients in Arm B received external beam radiotherapy to a dose of 20 Gy in 5 daily fractions of 4 Gy over one week. Following a treatment interval of 3 weeks, an identical second course was administered, resulting in a total planned dose of 40 Gy in 10 fractions.
Radiotherapy Technique
All patients underwent conventional radiotherapy simulation in the supine position using appropriate immobilization devices. Treatment portals were planned to include the gross primary lesion and clinically or radiologically involved nodal regions with adequate margins. Parallel opposed lateral fields were predominantly employed.
Radiotherapy was delivered using Cobalt-60 teletherapy units, with dose prescription performed at the midplane along the central axis. Field reduction, shrinking portals, and spinal cord shielding were incorporated during subsequent phases of treatment whenever clinically indicated to maintain spinal cord dose within tolerance limits.
Supportive care measures including nutritional support, analgesics, oral hygiene measures, antibiotics, anti-inflammatory medications, and Ryle’s tube insertion were provided according to individual patient requirements during treatment and follow-up.
Baseline Evaluation
Pretreatment evaluation included detailed clinical history, physical examination, comprehensive head and neck assessment, and documentation of addiction history and associated comorbidities. Performance status was evaluated using the Karnofsky Performance Scale.
Baseline investigations included complete blood counts, renal and liver function tests, chest radiography, ultrasonography of the abdomen, and contrast-enhanced computed tomography of the head and neck region for locoregional staging.
Tumor staging was performed according to the American Joint Committee on Cancer (AJCC) 8th edition staging system.
Response Assessment and Definitions
Clinical response assessment was performed using World Health Organization response criteria based on physical examination findings and symptomatic improvement at treatment completion and follow-up visits.
Complete response was defined as disappearance of all clinically detectable disease. Partial response was defined as ≥50% reduction in measurable disease burden. Stable disease was defined as <50>
Acute radiation-related toxicities were graded according to Radiation Therapy Oncology Group acute radiation morbidity criteria.
Treatment compliance was defined as completion of the planned radiotherapy schedule without permanent discontinuation. Overall survival was calculated from the date of randomization to the date of death or last follow-up.
Quality of life was assessed using the University of Washington Quality of Life Questionnaire version 4 (UWQOL v4), which evaluates multiple functional and psychosocial domains relevant to head and neck cancer patients. Performance status was assessed using the Karnofsky Performance Scale.
Assessments were performed at baseline, upon completion of radiotherapy, and at the first post-treatment follow-up visit approximately one month after treatment completion.
Follow-up
Following completion of radiotherapy, patients were regularly evaluated in the outpatient department. Follow-up assessments included evaluation of symptom relief, treatment response, toxicities, nutritional status, supportive care requirements, and suitability for further palliative systemic therapy.
Radiological investigations during follow-up were performed selectively whenever clinically indicated rather than routinely, considering the palliative intent of treatment, patient compliance, and resource limitations.
Statistics
Sample size estimation was based on anticipated differences in quality-of-life outcomes between the two treatment groups derived from previously published studies evaluating hypofractionated palliative radiotherapy schedules in head and neck cancers. Assuming a significance level (α) of 0.05 and statistical power of 80%, with adjustment for expected attrition in this palliative population, a minimum sample size of 28 patients per arm was calculated.
To account for possible treatment default, mortality, and loss to follow-up, the final sample size was increased to 35 patients per arm, resulting in a total study population of 70 patients.
Data were entered into Microsoft Excel and analyzed using Statistical Package for the Social Sciences (SPSS) software version 26.0 (IBM Corp., Armonk, NY, USA).
Continuous variables were expressed as mean ± standard deviation or median with range, while categorical variables were summarized as frequencies and percentages. Intergroup comparisons for categorical variables were performed using Chi-square test or Fisher’s exact test, as appropriate. Paired comparisons within treatment groups were analyzed using paired Student’s t-test. Survival analysis was performed using the Kaplan-Meier method, and differences between survival curves were assessed using the log-rank test.
A p-value <0>
Patient Recruitment and CONSORT Flow
Between January 2024 and December 2025, a total of 86 patients with locally advanced head and neck squamous cell carcinoma were screened for eligibility. Of these, 70 patients fulfilling the inclusion criteria were enrolled and randomized equally into two treatment arms (35 patients in each arm). Eight patients did not meet inclusion criteria, while another eight declined participation or were unsuitable for enrolment due to poor general condition.
In Arm A (Quad Shot regimen), 28 patients (80.0%) completed the planned treatment schedule, whereas 7 patients (20.0%) defaulted during treatment or follow-up. In Arm B (short-course hypofractionated regimen), 25 patients (71.4%) completed treatment and 10 patients (28.6%) defaulted. Patients who defaulted were excluded from final response assessment wherever complete follow-up data were unavailable. The patient selection and treatment allocation process is summarized in the CONSORT flow diagram (Figure 1).
Figure 1: CONSORT Flow Diagram of Patient Recruitment, Treatment Allocation, and Analysis.
Baseline Patient and Disease Characteristics
Baseline demographic and disease-related characteristics were comparable between the two treatment arms. The median age was 52.0 years in Arm A and 53.0 years in Arm B. Male predominance was observed in both groups. Tobacco use was the most common addiction history.
The oral cavity represented the predominant primary tumor site in both arms. Most patients presented with stage IVA or IVB disease and had poor baseline nutritional and performance status.These characteristics has been described in Table 1.
| Variable | Arm A (n=35) | Arm B (n=35) | p-value |
|---|---|---|---|
| Median age (years) | 52.0 | 53.0 | 0.684 |
| Male gender, n (%) | 30 (85.7) | 25 (71.4) | 0.142 |
| Tobacco use, n (%) | 30 (85.7) | 28 (80.0) | 0.518 |
| Smoking history, n (%) | 20 (57.1) | 24 (68.6) | 0.319 |
| Alcohol use, n (%) | 7 (20.0) | 2 (5.7) | 0.072 |
| Oral cavity primary, n (%) | 30 (85.7) | 27 (77.1) | 0.347 |
| Stage IVA disease, n (%) | 25 (71.4) | 17 (48.6) | 0.051 |
| Stage IVB disease, n (%) | 10 (28.6) | 18 (51.4) | 0.051 |
Table 1: Baseline patient and disease characteristics
Treatment Compliance
Treatment completion was higher in the Quad Shot arm compared with the short-course hypofractionated arm (80.0% vs. 71.4%). Treatment default occurred in 7 patients in Arm A and 10 patients in Arm B.
The common causes of treatment non-compliance included poor performance status, progressive clinical deterioration, socioeconomic limitations, travel-related difficulties, and lack of caregiver support.
Supportive Interventions
Nutritional compromise and dysphagia were common at presentation. Overall, 28 patients (40.0%) required Ryle’s tube insertion either before or during treatment.
Requirement for enteral nutritional support was more frequently observed in patients with oral cavity and oropharyngeal malignancies associated with severe dysphagia and poor oral intake.
Post-radiotherapy Palliative Chemotherapy
Improvement in performance status following radiotherapy enabled several patients to receive additional systemic therapy.
In Arm A, 12 patients (34.3%) received palliative chemotherapy following completion of radiotherapy, whereas 14 patients (40.0%) in Arm B subsequently received systemic treatment. The most commonly administered regimen was weekly methotrexate with or without oral gefitinib. A limited number of patients in Arm A additionally received paclitaxel-carboplatin–based chemotherapy.
Overall, 26 patients (49%) were able to tolerate further palliative systemic treatment after radiotherapy.
Acute Toxicity Profile
Both treatment schedules were generally well tolerated. Most toxicities were Grade 1–2 mucositis and dermatitis managed conservatively with supportive care.
Grade 3 mucositis was observed in one patient (2.9%) in Arm A, while no patient in Arm B developed Grade 3 mucositis. No Grade 3 or higher dermatitis was observed in either arm. No treatment-related mortality occurred during the study period. All toxicities has been analysed in Table 2.
| Toxicity | Arm A (n=35) | Arm B (n=35) | p-value |
|---|---|---|---|
| Grade 1–2 mucositis, n (%) | 24 (68.6) | 23 (65.7) | 0.796 |
| Grade 3 mucositis, n (%) | 1 (2.9) | 0 | 0.314 |
| Grade 1–2 dermatitis, n (%) | 18 (51.4) | 20 (57.1) | 0.632 |
| Grade ≥3 dermatitis, n (%) | 0 | 0 | — |
Table 2: Acute radiation toxicity profile
Clinical Tumor and Nodal Response
Clinical response assessment at treatment completion demonstrated high response rates in both treatment groups.
Partial response was observed in 27 of 28 evaluable patients (96.4%) in Arm A and 24 of 25 evaluable patients (96.0%) in Arm B. Stable disease was observed in one patient in each treatment arm. No patient demonstrated progressive disease during initial post-treatment assessment.
Complete nodal response was achieved in 75.0% of patients in Arm A and 72.0% in Arm B. Overall Response has been grouped in Table 3. Tumor response has been depicted in figure 2 and nodal response in figure 3.
| Response | Arm A (%) | Arm B (%) | p-value |
|---|---|---|---|
| Partial response | 96.4 | 96.0 | 0.948 |
| Stable disease | 3.6 | 4.0 | 0.948 |
| Progressive disease | 0 | 0 | — |
| Complete nodal response | 75.0 | 72.0 | 0.781 |
Table 3: Clinical response assessment
Figure 2: Overall Tumor response assessment.
Figure 3: Overall Nodal response assessment.
Performance Status Outcomes
A statistically significant improvement in Karnofsky Performance Status (KPS) was observed following treatment in both groups (p<0>
In Arm A, mean KPS improved from 47.9 ± 9.2 at baseline to 63.9 ± 7.9 post-treatment. In Arm B, mean KPS improved from 50.8 ± 11.5 to 64.0 ± 9.6 following treatment.
The magnitude of performance status improvement was marginally greater in the Quad Shot arm and this has been shown in Table 4.
| Parameter | Arm A | Arm B | p-value |
|---|---|---|---|
| Pretreatment KPS (mean ± SD) | 47.9 ± 9.2 | 50.8 ± 11.5 | 0.246 |
| Post-treatment KPS (mean ± SD) | 63.9 ± 7.9 | 64.0 ± 9.6 | 0.964 |
| Within-group improvement | p<0> | p<0> | — |
Table 4: Karnofsky Performance Status improvement
Quality-of-Life Outcomes
Quality-of-life assessment using UWQOL version 4 demonstrated significant improvement across multiple functional and psychosocial domains following treatment in both arms.
Substantial improvement was observed in pain, swallowing, speech, activity, mood, anxiety, and social functioning scores. However, worsening of taste and salivary function was noted after radiotherapy in both treatment groups.
Overall quality-of-life scores improved from 22.5 ± 11.6 to 68.8 ± 19.9 in Arm A and from 22.6 ± 13.0 to 68.6 ± 18.6 in Arm B (p<0>
| Domain | Arm A Pre (Mean ± SD) | Arm A Post | p-value | Arm B Pre | Arm B Post | p-value |
|---|---|---|---|---|---|---|
| Pain | 17.6 ± 11.6 | 88.6 ± 21.2 | <0> | 34.4 ± 14.4 | 89.7 ± 17.6 | <0> |
| Appearance | 38.2 ± 19.7 | 83.9 ± 15.3 | <0> | 37.5 ± 14.7 | 77.1 ± 12.6 | <0> |
| Activity | 38.4 ± 15.9 | 76.8 ± 16.6 | <0> | 42.7 ± 15.6 | 66.7 ± 17.6 | <0> |
| Recreation | 36.6 ± 15.9 | 68.8 ± 27.7 | <0> | 49.0 ± 11.6 | 69.8 ± 12.7 | <0> |
| Swallowing | 34.4 ± 19.3 | 66.8 ± 20.4 | <0> | 38.7 ± 16.3 | 72.5 ± 16.0 | <0> |
| Chewing | 16.1 ± 17.0 | 49.1 ± 35.0 | <0> | 19.8 ± 12.7 | 37.5 ± 22.1 | <0> |
| Speech | 34.5 ± 26.6 | 74.0 ± 24.6 | <0> | 33.0 ± — | 61.3 ± 12.9 | <0> |
| Shoulder | 3.0 ± 8.8 | 7.4 ± 15.4 | 0.096 | 1.3 ± 6.6 | 6.6 ± 13.5 | 0.043 |
| Taste | 45.1 ± 20.9 | 10.7 ± 22.4 | <0> | 41.5 ± 18.0 | 8.3 ± 14.6 | <0> |
| Saliva | 19.0 ± 24.8 | 4.7 ± 11.8 | <0> | 35.7 ± 9.4 | 2.6 ± 9.1 | <0> |
| Mood | 42.9 ± 19.1 | 77.7 ± 20.8 | <0> | 33.3 ± 19.0 | 67.7 ± 18.8 | <0> |
| Anxiety | 35.5 ± 18.1 | 72.7 ± 25.8 | <0> | 37.3 ± 11.5 | 71.1 ± 11.2 | <0> |
| Physical Domain Score | 42.7 ± 20.3 | 85.6 ± 19.4 | <0> | 42.4 ± 17.9 | 84.2 ± 19.9 | <0> |
| Social Domain Score | 33.5 ± 18.4 | 78.6 ± 16.5 | <0> | 32.9 ± 18.2 | 77.6 ± 16.7 | <0> |
| Overall QOL Score | 22.5 ± 11.6 | 68.8 ± 19.9 | <0> | 22.6 ± 13.0 | 68.6 ± 18.6 | <0> |
Table 5: Quality of life analysis
Survival Outcomes
The median follow-up duration ranged from 6.0 to 21.0 months.
Median overall survival was 4.0 months (95% CI: 2.7–5.3) in Arm A compared with 3.5 months (95% CI: 1.3–4.6) in Arm B as illustrated in Table 6. Although a trend toward improved survival was observed in the Quad Shot arm, the difference did not reach statistical significance (log-rank p=0.284). Kaplan–Meier survival analysis is depicted in Figure 4.
| Treatment Arm | Median overall survival (months) | 95% CI | p-value |
|---|---|---|---|
| Arm A | 4.0 | 2.7–5.3 | 0.284 |
| Arm B | 3.5 | 1.3–4.6 | 0.284 |
Table 6. Overall survival outcomes
Figure 4. Kaplan–Meier overall survival curves comparing the two treatment arms along with number-at-risk table
Management of incurable locally advanced head and neck squamous cell carcinoma continues to be challenging in routine oncology practice, particularly in countries with high disease burden and limited healthcare resources. Many patients present with extensive locoregional disease accompanied by malnutrition, compromised airway or swallowing function, severe pain, and poor performance status, making curative treatment impractical. In such circumstances, the principal goals of treatment shift toward symptom reduction, preservation of dignity, maintenance of functional capacity, and improvement of patient comfort.
Hypofractionated palliative radiotherapy schedules are increasingly utilized because they allow rapid symptom control with fewer treatment visits and reduced interruption to supportive care. These schedules are especially valuable in frail patients who may not tolerate prolonged treatment courses. The present prospective randomized study compared two commonly used hypofractionated regimens and demonstrated that both approaches achieved meaningful palliation with acceptable acute toxicity.
The demographic and clinicopathological characteristics observed in the present study were comparable with previously published Indian and international studies evaluating palliative radiotherapy in advanced head and neck cancers. Male predominance and the high prevalence of tobacco-related habits observed in our study reflect the established epidemiological profile of head and neck cancers in the Indian population.
Treatment adherence was numerically superior in the Quad Shot arm compared with the short-course hypofractionated schedule. Improved compliance in the Quad Shot group may be attributable to the shorter cyclical treatment delivery, reduced uninterrupted treatment burden, and better patient tolerance. Similar observations regarding feasibility and patient acceptability of the Quad Shot approach have been described in previous palliative radiotherapy studies involving advanced head and neck cancers.
Both treatment regimens produced high rates of objective clinical response. More than 95% of evaluable patients in each arm demonstrated partial response following treatment completion, indicating comparable palliative efficacy between the two schedules. Earlier studies evaluating hypofractionated radiotherapy in advanced head and neck malignancies have likewise reported rapid symptomatic improvement and encouraging local disease control using abbreviated treatment schedules.
Performance status improved significantly following treatment in both study arms. Improvement in Karnofsky Performance Status after palliative radiotherapy has also been reported in earlier studies and is clinically relevant because better functional status may improve oral intake, reduce caregiver dependence, and facilitate further supportive or systemic therapy.
Meaningful improvement in patient-reported quality-of-life outcomes was observed after treatment in both study groups. Domains related to pain relief, swallowing, mood, social interaction, and daily activity showed substantial post-treatment improvement. These findings support the role of palliative radiotherapy not only in tumor control but also in restoration of functional well-being and psychosocial comfort. The relatively favorable compliance observed with the Quad Shot regimen may additionally have contributed to sustained symptom relief.
Acute treatment-related adverse effects remained manageable in both treatment arms. Most patients developed only mild-to-moderate mucosal and skin reactions that responded adequately to conservative supportive measures. Severe mucositis was uncommon and no treatment-related mortality occurred. These findings further support the practical feasibility of hypofractionated palliative radiotherapy even among patients with compromised nutritional and functional status.
Median overall survival was 4.0 months in the Quad Shot arm and 3.5 months in the short-course hypofractionated arm. Although the difference was not statistically significant, a modest survival advantage was observed with the Quad Shot regimen. Previous studies evaluating palliative radiotherapy in advanced head and neck cancers have reported median survival durations ranging from approximately 3 to 6 months depending on baseline disease burden, nutritional status, and subsequent systemic therapy.
The present study has certain limitations. It was conducted at a single institution with a relatively small sample size and limited follow-up duration. In addition, radiological response assessment could not be uniformly performed in all patients because of logistical and financial constraints. Nevertheless, the prospective randomized design and inclusion of quality-of-life assessment strengthen the clinical relevance of the study.
Taken together, the findings of the present study suggest that both hypofractionated schedules are clinically effective options for palliation in incurable LAHNSCC. However, the Quad Shot regimen demonstrated relatively better treatment adherence along with a modest improvement in survival outcomes, supporting its utility as a pragmatic and patient-friendly approach in high-volume oncology centers and resource-limited settings.
Both the Quad Shot regimen and short-course hypofractionated radiotherapy provided effective symptom palliation with acceptable toxicity in patients with incurable locally advanced head and neck squamous cell carcinoma. Both schedules achieved high clinical response rates with significant improvement in performance status and quality of life.
The Quad Shot regimen demonstrated comparatively better treatment compliance, favorable tolerability, and modest survival benefit, supporting its practical applicability in frail patients and resource-constrained settings. These findings reinforce the role of hypofractionated palliative radiotherapy as an effective and feasible approach for symptom control in advanced incurable head and neck cancers.
Further multicentric studies with larger sample sizes and integration of modern radiotherapy techniques and systemic therapies are warranted to optimize palliative treatment strategies in this patient population.
Nil
The authors declare no conflicts of interest.
The authors sincerely acknowledge the support provided by the faculty, residents, nursing staff, radiation technologists, and supportive care teams of the Department of Radiation Oncology for their assistance during patient management and data collection throughout the study period.
The authors are also grateful to all the patients and their caregivers who participated in the study despite challenging clinical circumstances.
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Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
