Author of

• 11645

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  P2.08 - Poster Session 2 - Radiotherapy (ID 198)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Radiation Oncology + Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11661

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    P2.08-016 - Use of palliative radiotherapy in lung cancer during the last weeks of the life. (ID 1996)

    09:30 - 09:30  |  Author(s): A. Tursunovic
    • Abstract

    Background
    Radiotherapy (RT) is commonly used for palliation of symptoms in patients with lung cancer. However, the time before onset of relief may be several weeks. It is therefore of interest to study how many patients who die within few weeks after the initiation RT since these patients are not likely to benefit from the treatment.

    Methods
    This is a retrospective review of the overall survival rate of 293 patients with lung cancer who received palliative RT in 2010 at our institution. If patients had received more than one course of RT, only data from the last course was included in the study.

    Results
    The planned fractionation (F) schedules were 8Gy/1F(N=34), 10Gy/1F(N=34), 20Gy/4-5F(N=16), 20Gy/10F(N=2), 25Gy/5F(N=44), and 30Gy/10F(N=167). The median survival was 11.9 weeks. The two-week mortality rate 10.2% and the four-week mortality rate was 22.2%.

    	N	2 week mortality	4 week mortality	Median survival
    8-10 Gy/1F	64	15 (23%)	26 (41%)	5.6 w
    20-25Gy/4-5F	60	8 (13%)	20 (33%)	6.0 w
    20-30Gy/10F	169	7 (4%)	19 (11%)	21.7 w
    Total	293	30 (10%)	65 (22%)	11.9 w

    Among the patients planned for 4-5F, only one patients (2%) did not receive the planned number of fractions, while 13 patients (8%) of the patients planned for 10F did not receive the planned number of fractions. In a logistic regression analysis using 2-week mortality as endpoint, only planned number of fractions <10F and bone metastases as indication of RT were significant factors for poor survival, while gender, CNS metastases, age, performance status and histology were not. The results are strikingly similar to Gupta et al. Radiother. Oncol. 2012;103 suppl.1(PO-0744).

    Conclusion
    Although 10% of the patients receiving palliative RT die within 2 weeks from the start of RT, the results indicate that prolonged treatment regimens were reserved for patients with longer life expectation. Nearly 1 of 4 of patients receiving 1F died within two weeks after start of RT indicating that the RT was futile in these patients.The radiation oncologists seem to expect a palliative effect of RT for bone metastases even in patients with short life expectations.