March 17, 2010 - Researchers found a two-week break in radiation therapy for patients with stage I small cell lung cancer, who have gone through surgery, reduced patients' symptoms without adversely affecting cancer survival, reports the February issue of the Journal of Thoracic Oncology.
While the majority of lung cancer patients present with locally advanced or stage IV disease, the primary challenge in treating them is that most present with poor performance status, and the benefit of treatment may be doubtful because of poor tolerance to any form of therapy.
Palliative chest radiotherapy for lung malignancies has shown to be effective in relieving serious chest symptoms from tumor bleeding or mass effect on major airways, vessels and nerves. However, there is a lack of consensus for an optimal palliative RT regimen.
Researchers sought to assess the overall efficacy of split-course palliative chest RT for symptom relief in patients with advanced non-small cell lung cancer. Additionally, researchers investigated the impact the regimen’s two-week break has on survival outcomes.
Investigators reviewed the records of 140 patients treated between 1995 and 2006, who were prescribed to an initial 25 Gy in 10 fractions through anterior-posterior/posterior-anterior beam arrangements. After two weeks of rest, selected patients were given an additional 10 Gy (anterior-posterior/posterior-anterior) followed by off-cord beams to a final dose of 50 to 62.5 Gy.
Symptomatic relief was observed in 52 to 84 percent of patients with durable palliation in 58 percent. The researchers observed: "The built-in two-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." The researchers added that the two-week break may be an option for patients who cannot tolerate an uninterrupted course.
Reference: Metcalfe, Su K.; Milano, Michael T.; Bylund, Kevin; Smudzin, Therese; Rubin, Philip; Chen, Yuhchyau. Split-Course Palliative Radiotherapy for Advanced Non-small Cell Lung Cancer. Journal of Thoracic Oncology. 5(2):185-190, February 2010.
For more information: journals.lww.com/jto/toc/2010/02000