Comparison of Two Palliative Radiotherapy Schedules for Locally Advanced Non-Small-Cell Lung Cancer (NSCLC)
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- Category: Vol. 80, March 2012
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Comparison of Two Palliative Radiotherapy Schedules for Locally Advanced Non-Small-Cell Lung Cancer (NSCLC),FATMA M.F. AKL, EMAN H. ELZAHAF and RAED EL-METWALLY ALI
Abstract
Background and Objective: Lung cancer has been esti-mated as the most common cancer in the world for several decades. An estimated 1.61 million people across the world were diagnosed with lung cancer in 2008, accounting for 13% of the total, and it is the most common cause of death from cancer worldwide. The aim of our study was to compare between two palliative radiotherapy schedules, a 17Gy/2 fraction (fr) schedule to the commonly used 20 Gy/5 fraction regimen in terms of palliation of thoracic symptoms, toxicity and survival.
Patients and Methods: A prospective randomized study was conducted on 36 patients with histopathologically proven NSCLC. Eligibility criteria included pathologically confirmed NSCLC not suitable for radical treatment, the presence of symptoms related to chest tumour (cough, dyspnea, haemop-tysis and chest pain), age >18 years, WHO performance status >!2 and expected survival of at least 3 months. Patients were randomized to receive either 20Gy in 5 fractions over 5 consecutive days (arm I) or 17Gy in 2 fractions 1 week apart (arm II).
Results: No significant difference regarding clinical symptomatic response was detected between the two treatment arms (p=0.9). Grade I esophagitis was the only reported toxicity in both arms (10.5% and 11.8% respectively) (p=0.9). The median overall survival time was 10 months (95% confi-dence interval CI: 6.8-13.2) (range: 4-18 months) in arm I and 9 months (CI: 7.01-10.9) (range: 4-17 months) in arm II with insignificant p-value (p=0.7). The 1-year overall survival were 36% and 29% in arm I and arm II, respectively. Multi-variate analysis of overall survival with age, stage, pathologic type, performance status and treatment arm revealed that performance status was the only significant prognostic variable (p=0.001).
Conclusion: Our study confirmed the equal efficacy of the two short palliative radiotherapy schedules in terms of palliative effect, treatment tolerance and overall survival.