Novel, complex, resource intensive, radiation technology is increasingly used for palliative therapy even though they are not cost effective in poor prognosis pts. (Kim IJROBP 2015;556). Since nearly half of all radiotherapy (RT) activity is palliative (Hoskin Cl Onc 2013;531), objective, validated prognostic tools are urgently needed to guide cost effective utilisation of RT. As advanced cancer is associated with poor nutritional status and immune dysfunction, we assessed prognostic role of PNI-which is based on serum albumin & peripheral blood lymphocytes.
Mortality of 233 unselected cancer pts treated over a 3 month at Nottingham was assessed. All tumour sites & histology were included. Overall Median age 68 yrs. Sites of RT field: Chest=29% Vertebrae=26% Pelvis=20% Brain=12% Limbs=6% Abd=3% Miscell=3%. 95% completed RT as planned. 93% had stage 4 cancer. PNI available for 131 pts. Majority not suitable for systemic therapy following palliative RT; only 15% and 28% had further hormones and chemo respectively.
Overall Median survival was 5.82 months; 38% died within 90 days of completing RT; Pts with low PNI (
For terminally ill cancer patients, who are not fit for further systemic therapy and whose PNI is
Clinical trial identification
Legal entity responsible for the study
All authors have declared no conflicts of interest.