Abstract 1235P
Background
In an effort to improve symptom palliation, palliative thoracic radiotherapy (TRT) has been integrated into various palliative approaches in patients with advanced non-small cell lung cancer (NSCLC). Palliative TRT can effectively palliate locoregional symptoms like haemoptysis, cough, shortness of breath, chest pain. Palliative TRT can be given using both hypofractionated and multifractionated regimens. Hypofractionated regimens are convenient to deliver and also cost-effective. Furthermore, hypofractionated palliative TRT may release radiotherapy sources and make radiotherapy more available for other groups of cancer patients.
Methods
Sixty patients of advanced NSCLC were randomly allocated to either palliative TRT 8.5 GY per fraction 1week apart (total dose 17 Gy) or 39 Gy in 13 fractions five days per week. They were followed up for 6 months at the OPD. Symptomatic response to the treatments, tumor response, and grade and frequency of toxic effects were the outcome measures. The symptomatic response was measured using a quantitative scoring system of cough, modified Medical Research Council dyspnea scale, haemoptysis grading, four-point scale for assessment of chest pain. Radiation toxicities were assessed according to RTOG Acute Radiation Morbidity Criteria.
Results
Both treatment groups were comparable in terms of baseline characteristics including age, tumor stage, and symptom distribution. Palliation of the main symptoms was achieved similarly in both groups. Cough, dyspnea, hemoptysis and chest pain were palliated in respectively in 16.7%, 46.7%, 56.7% and 66.7% in 17 Gy × 2 group. The corresponding figures in 39 ×13 Gy group were 23.3%, 60%, 46.7% and 83.3% respectively. Dermatitis and esophagitis were the treatment toxicities with similar distribution in both groups. There was no change in performance status and tumor response in the entire cohort.
Conclusions
It can be concluded that short-term hypofractionated treatment renders similar improvement in symptom relief and safety when compared with protracted palliative TRT in advanced NSCLC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.