Document Detail


Split-course palliative radiotherapy for advanced non-small cell lung cancer.
MedLine Citation:
PMID:  20009771     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Palliative chest radiotherapy (RT) for lung malignancies is effective in relieving serious chest symptoms from tumor bleeding or mass effect on major airways, vessels, and nerves. Albeit an important subject, there is a lack of consensus for an optimal palliative RT regimen. We report the outcomes of a split-course palliative chest RT, a frequently used schema at our institution. METHODS AND MATERIALS: Records of 140 patients treated between 1995 and 2006 were reviewed. Treatment was prescribed to an initial 25 Gy in 10 fractions through anterior-posterior/posterior-anterior beam arrangements. After a 2-week rest period, patients were selected to receive an additional 10 Gy (anterior-posterior/posterior-anterior) followed by off-cord beams to a final dose of 50 to 62.5 Gy. Symptom relief and toxicity during RT and after completion of RT were assessed from clinician notes and patient-reported symptom inventory forms. Second, the impact on survival was assessed. RESULTS: Symptomatic relief was observed in 52 to 84% of patients with durable palliation in 58%. There were no grade 3 to 5 toxicities. Grades 1 and 2 esophagitis and pneumonitis were observed in 34 and 8% patients, respectively. Median survival was 5 months. CONCLUSIONS: A majority of patients experienced symptomatic improvement. The built-in 2-week break allowed for selection of patients for high-dose palliative radiation and balanced treatment benefits with potential side effects. Cancer survival was not adversely affected by treatments in this population with mostly advanced disease. This regimen is a viable option for patients who cannot tolerate a protracted, uninterrupted course of treatment.
Authors:
Su K Metcalfe; Michael T Milano; Kevin Bylund; Therese Smudzin; Philip Rubin; Yuhchyau Chen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer     Volume:  5     ISSN:  1556-1380     ISO Abbreviation:  J Thorac Oncol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274235     Medline TA:  J Thorac Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-90     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, James P. Wilmot Cancer Center, University of Rochester, Rochester, New York, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / pathology,  radiotherapy*
Dose Fractionation
Female
Humans
Lung Neoplasms / pathology,  radiotherapy*
Male
Middle Aged
Neoplasm Staging
Palliative Care*
Proportional Hazards Models
Radiotherapy Dosage
Retrospective Studies
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Does the ratio of serum aldosterone to plasma renin activity predict the efficacy of diuretics in hy...
Next Document:  Can a Thoracic Surgeon Identify Lymph Node Metastases during Surgery Based on Their Size?: Analysis ...