JTO: Split-course RT results in symptom relief; no change to survival

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Split-course palliative chest radiotherapy (RT) can result in symptom relief for patients with advanced non-small cell lung cancer without adversely affecting survival rates, according to a study published in the February edition of the Journal of Thoracic Oncology.

Su Metcalfe, MD, from the James P. Wilmot Cancer Center at the University of Rochester, and colleagues reviewed the records of 140 patients treated between 1995 and 2006. Patients were treated with an initial 25 Gy in 10 fractions through anterior-posterior/posterior-anterior beam arrangements.

After a two-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. Using clinician notes and patient-reported symptom inventory forms, they evaluated symptom relief and toxicity during and after completion of radiotherapy. Then, the researchers assessed the results according to the treatment’s effect on survival rates.

Metcalfe and colleagues found that symptomatic relief was observed in 52 to 84 percent of the patients, with long-lasting symptom relief found in 58 percent of the cases. There were no grade 3 to 5 toxicities. Grades 1 and 2 esophagitis and pneumonitis were observed in 34 percent of patients and 8 percent of patients, respectively. The median survival was five months.

“Cancer survival was not adversely affected by treatments in this population with mostly advanced disease,” concluded the researchers, who added that this radiotherapy regimen “is a viable option for patients who cannot tolerate a protracted, uninterrupted course of treatment.”