Title |
Fractionated palliative thoracic radiotherapy in non-small cell lung cancer – futile or worth-while?
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Published in |
BMC Palliative Care, January 2018
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DOI | 10.1186/s12904-017-0270-4 |
Pubmed ID | |
Authors |
Malene Støchkel Frank, Dorte Schou Nørøxe, Lotte Nygård, Gitte Fredberg Persson |
Abstract |
Palliative thoracic radiotherapy (PTR) can relieve symptoms originating from intra-thoracic disease. The optimal timing and fractionation of PTR is unknown. Time to effect is 2 months. The primary aim of this retrospective study was to investigate survival after PTR, hypothesizing that a significant number of patients received futile fractionated PTR. The secondary aim was to find prognostic factors to guide treatment decisions. Patients with non-small-cell lung cancer (NSCLC) planned for PTR in the period of 2010-2011 at the University Hospital of Copenhagen were included. We noted pathology, tumor, node and metastasis (TNM) classification of malignant tumors, stage, indication, start date, schedule for PTR, completed y/n, performance status (PS) and time of death. Analyses were performed as an intention-to-treat using Cox regression, Fishers exact test and Kaplan Meier. A total of 159 patients were included. Median overall survival (OS) was 4.2 months. Sixteen patients (10%) did either not begin or finish PTR. Of these, eight (5%) died prior to or during PTR. Of the 151 patients receiving PTR, sixteen patients (11%) died within 14 days, thirty-three (22%) within 30 days and fifty (33%) within 2 months. PS 0-1 and squamous cell carcinoma were correlated with a better survival. Our study show that a significant number of patients who received PTR died before they could achieve optimal effect of the treatment. PS and histology were significant prognostic factors favoring PS 0-1 and squamous cell carcinoma. Based on our study, we suggest that patients with PS 0-1 should be considered for fractionated PTR whereas patients with PS ≥ 2 should be considered for high dose single fraction only or supportive palliative care. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 27 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 4 | 15% |
Student > Master | 4 | 15% |
Student > Doctoral Student | 3 | 11% |
Researcher | 3 | 11% |
Student > Postgraduate | 2 | 7% |
Other | 1 | 4% |
Unknown | 10 | 37% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 9 | 33% |
Nursing and Health Professions | 5 | 19% |
Computer Science | 1 | 4% |
Unknown | 12 | 44% |