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[Palliative radiotherapy in non-small cell bronchial carcinoma]
B J Slotman1, K H Njo, A B Karim
1Academisch Ziekenhuis Vrije Universiteit, afd. Radiotherapie, Amsterdam.
Objective:
Evaluation of palliative radiotherapy for patients with non-small cell lung cancer.
Design:
Descriptive study.
Location:
University hospital Vrije Universiteit, Amsterdam.
Method:
Between 1987 and 1991, 146 patients with stage IIIB or IV non-small cell lung cancer received palliative radiotherapy for symptoms of intrathoracic tumour growth. There were 144 evaluable patients and all of them received three fractions of 800 cGy (1 fraction per week).
Results:
Median survival was 6.3 months for stage IIIB and 4.2 months for stage IV patients (p < 0.005). Stage IIIB patients with a Karnofsky performance score of 70 and above showed significantly (p < 0.01) longer survival than those with a performance score below 70. Local progression was recorded in 61.1% of patients. However, 68.8% of the patients were free of local progression for at least 75% of their remaining survival time. The toxicity of the treatment was acceptable.
Conclusion:
On the basis of these results and results of other studies, it is concluded that the palliative effect of a small number of sessions with high fraction doses is comparable with that achieved with a more fractionated schedule. A short course of radiotherapy is preferable to minimize inconvenience for the patient as well as for the radiotherapy department.