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Low-dose palliative splenic irradiation in haematolymphoid malignancy
R K Shrimali1, P D Correa, N O'Rourke
1Department of Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK. dr_shrimali@hotmail.com
Journal of Medical Imaging and Radiation Oncology
|May 15, 2008
Summary
Palliative splenic irradiation (SI) effectively relieves pain and symptoms in most patients. However, SI shows limited success in improving abnormal blood counts, indicating its primary benefit is symptom management.
Area of Science:
- Oncology
- Radiotherapy
Background:
- Palliative splenic irradiation (SI) is used to manage pain, volume effects, and hypersplenism.
- The spleen plays a role in various hematological conditions and can cause significant symptoms.
Purpose of the Study:
- To evaluate the effectiveness of palliative splenic irradiation (SI) in symptom palliation and hematological response.
- To assess the outcomes of SI in patients with splenic-related symptoms and hypersplenism.
Main Methods:
- Retrospective review of 19 patients treated with 22 courses of palliative SI between April 2003 and November 2004.
- Doses ranged from 150 to 800 cGy (median 450 cGy) with fraction sizes of 25 to 100 cGy.
- Common field arrangement involved parallel-opposed anteroposterior-posteroanterior portals; target volume was reduced in 18 courses.
Main Results:
- Symptomatic palliation was achieved in 12 of 14 courses (85.7%).
- Effective palliation was observed in 17 of 20 courses (85%) initiated for symptom control.
- Hematological response was achieved in only 1 of 6 courses (16.7%) for combined symptoms and abnormal blood tests, and 1 of 2 courses (50%) for abnormal blood counts alone.
Conclusions:
- Palliative splenic irradiation is an effective and well-tolerated treatment for symptomatic relief in patients with splenic conditions.
- SI demonstrates limited efficacy in correcting abnormal blood counts compared to its effectiveness in symptom palliation.
