Palliative thoracic radiotherapy for patients with advanced non-small cell lung cancer and poor performance status. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Walasek, Tomasz; Sas-Korczyńska, Beata; Dąbrowski, Tomasz; Reinfuss, Marian; Jakubowicz, Jerzy; Blecharz, Paweł; Łuczyńska, Elżbieta; Darasz, Zbigniew; Skotnicki, Piotr
• Is Part Of: Lung cancer. Volume 87:Issue 2(2015:Feb.)
• Page Start: 130
• Page End: 135
• Publication Date: 2015-02
• Subjects: NSCLC -- Performance status -- Palliative thoracic radiotherapy -- Supportive care -- Life expectancy -- Advanced lung cancer; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2014.11.015
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Evaluation of efficacy of palliative thoracic radiotherapy (PTR) and supportive care (SC) alone in patients with advanced NSCLC. 90-day overall survival rate was 20.0% (PTR), and 18.2% (SC). Tolerance and early toxicity of PTR was poor. Effective method of treatment for patients with advanced NSCLC is modern supportive care rather than PTR. Summary: Objective: The evaluation of efficacy of palliative thoracic radiotherapy (PTR) in patients with advanced non-small cell lung cancer (NSCLC) and to compare it with efficacy of supportive care (SC) alone. Materials and methods: Between 2000 and 2012, 235 patients with advanced NSCLC (IIIB and IV) and Karnofsky Performance Status accounted 40–30, were qualified to PTR. In fact, 125 (53.2%) out of them were treated with PTR, and 110 (46.8%)—with SC alone, in accordance with patients expectations. There were no differences between PTR and SC group with respect to patient and tumor characteristics as well as with respect to the type and incidence of symptoms related to the local growth of NSCLC. In all 125 PTR patients the delivered tumor dose was 20 Gy given in five daily fractions over five treatment days. All 110 patients who refused PTR were treated with SC in another hospital (28.2%), in a hospice (21.8%) or by general practitioners at home (50.0%). Results: The 90-day overall survival rate in the group of PTR patients was 20.0%, and in the group of SC patients it was 18.2%. Median survival amounted 58 and 59 days, respectively. The efficacy of PTR and SC, relative to the symptoms associated with the local growth of NSCLC, was comparable. Tolerance of PTR was poor and early toxicity—significant. Moreover 41.6% of irradiated patients received PTR within the last 30 days of their lives and 16.0% of these patients—within the last 15 days prior to death. Conclusion: The life expectancy of patients with advanced NSCLC and poor performance status (Karnofsky 40–30), who presenting moderate or severe symptoms related to the local growth of cancer, is measured in days or weeks. The effective method of treatment for these patients is modern supportive care rather than PTR.