Palliative radiotherapy in the UK

A number of different palliative radiotherapy techniques and fractionation schedules have been used in the UK over the past several years. In an attempt to standardize treatment practices, a handful of studies have been conducted in recent years compiling basic demographic data on the use of palliative radiotherapy as well as response data for the various techniques currently in use. In one study conducted at Mount Vernon Hospital, just outside of London, Maher and colleagues collected data on 425 consecutive patients given radiotherapy during a six-week period in 1988. Of those, 211 (49.6%) patients received radical treatment for long-term tumor control, and the remaining 214 (50.4%) patients received palliative treatment for symptom relief in the case of incurable cancer. Of the 214 patients treated with palliative radiotherapy, 90 (42%) patients were treated for bone secondaries, 63 (29%) patients for primary carcinoma of the bronchus, 12 (6%) patients for brain secondaries and 49 (23%) patients for other miscellaneous reasons. There is evidence that in the last few years British practice in palliative radiotherapy has changed substantially, largely as a result of the findings of recent clinical trials. This review will summarize the data relating to the radiotherapeutic management of bone secondaries, advanced lung cancer and cerebral metastases.