Short course palliative radiotherapy in advanced solid tumors: a pooled analysis (the SHARON project)

Area of Science:

• Oncology
• Palliative Care
• Radiotherapy

Background:

• Previous trials established the tolerability and efficacy of the SHARON palliative radiotherapy regimen.
• The SHARON regimen involves 4 fractions delivered over 2 days.
• Identifying predictors of symptomatic response is crucial for optimizing palliative care.

Purpose of the Study:

• To perform a pooled analysis of previous trials to identify predictors of symptomatic response to the SHARON regimen.
• To evaluate the impact of various parameters on symptomatic response.

Main Methods:

• Pooled analysis of data from 180 patients treated with the SHARON regimen.
• Statistical analysis using Chi-square and Fisher's exact tests.
• Evaluation of parameters including tumor site, histology, ECOG status, dominant symptom, and RT dose.

Main Results:

• Overall response rate was 88.8%, with significant reduction in pain (VAS scores decreased from 5.3 to 2.2).
• High response rates observed for pain (86.2%), dyspnea (90.9%), bleeding (100%), and dysphagia (87.5%).
• Patients with locally advanced disease showed higher response rates than metastatic ones (97.3% vs 83.0%).
• Complete pain response was significantly higher in patients with mild-moderate pain (36.0%) compared to severe pain (14.3%).

Conclusions:

• The SHARON regimen demonstrates high efficacy in relieving various cancer-related symptoms.
• Early referral for palliative radiotherapy is recommended for patients experiencing cancer-related pain, particularly those with mild to moderate pain.
• While most analyzed parameters did not predict response, disease stage and initial pain severity influenced outcomes.