Translate this page into:
Profile of patients undergoing palliative radiotherapy: A single-institute study from a tertiary care oncology center
*Corresponding author: Dr. B. S. Sunita. drsunitabs@gmail.com
This article was originally published by Thieme Medical and Scientific Publishers Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Abstract
Background: Palliative radiotherapy (PRT) plays a significant role in the palliation of symptoms in patients with cancer and constitutes nearly 50% of the workload in different settings. Aims: The aim is to study patient-, disease-, and treatment-related characteristics in locoregionally advanced and metastatic malignancies meriting palliative management. Setting and Design: This was a retrospective observational study in a tertiary care government institute with academic and research potential. Methodology: The electronic medical records, medical documents, and radiotherapy (RT) treatment charts were retrieved and studied. Observations: A total of 460 patients were included in the study over 2 years, forming 30% of the total number of patients treated during the study period. Three hundred and ninety-six patients received PRT to the metastatic sites, while 64 patients received extremely hypofractionated PRT to the primary for symptomatic relief. Totally 442 patients showed good symptomatic response to PRT. One hundred and thirty-eight patients underwent re-irradiation. Lung was the most common primary site seen in 155 cases. The most common indication for PRT was palliation of pain from painful metastases as seen in 240 cases, and the next common indication was palliative whole-brain RT for brain metastases as seen in 159 cases. Conclusion: PRT forms an integral and important aspect of palliative care to the vast number of patients harboring metastatic disease that warrants some form of treatment for symptomatic relief. Short course of PRT in outdoor setting is a preferred mode of treatment to improve the quality of life of these distressed patients.
Keywords
Acknowledgment
The authors would like to thank the departments of medical oncology, surgical oncology, pathology, and interventional radiology, for their support and guidance.
References
- Kapoor A, Singhal MK, Kumar N, Kalwar A, Bagri PK, Narayan S, et al. Analysis of patterns of palliative radiotherapy in North West India: A regional cancer center experience. Indian J Palliat Care 2015;21:168-73.
- Lutz ST, Jones J, Chow E. Role of radiation therapy in palliative care of the patient with cancer. J Clin Oncol 2014;32:2913-9.
- Sharma S, Hertan L, Jones J. Palliative radiotherapy: Current status and future directions. Semin Oncol 2014;41:751-63.
- Bourgier C, Charissoux M, Boisselier P, Ducteil A, Azria D. What type of hypofractionated radiotherapy of primary tumours in palliative care? Cancer Radiother 2015;19:442-5.
- van Oorschot B, Rades D, Schulze W, Beckmann G, Feyer P. Palliative radiotherapy – New approaches. Semin Oncol 2011;38:443-9.
- Jones JA, Simone CB 2nd. Palliative radiotherapy for advanced malignancies in a changing oncologic landscape: Guiding principles and practice implementation. Ann Palliat Med 2014;3:192-202.
- Lutz ST, Chow EL, Hartsell WF, Konski AA. A review of hypofractionated palliative radiotherapy. Cancer 2007;109:1462-70.
- Nieder C, Dalhaug A, Pawinski A, Haukland E, Mannsåker B, Engljähringer K, et al. Palliative radiotherapy with or without additional care by a multidisciplinary palliative care team in patients with newly diagnosed cancer: A retrospective matched pairs comparison. Radiat Oncol 2015;10:61.
- Holt TR, Yau VK. Innovative program for palliative radiotherapy in Australia. J Med Imaging Radiat Oncol 2010;54:76-81.
- Sharma K, Mohanti BK, Rath GK, Bhatnagar S. Pattern of palliative care, pain management and referral trends in patients receiving radiotherapy at a tertiary cancer center. Indian J Palliat Care 2009;15:148-54.
- Singhal MK, Kapoor A, Bagri PK, Singh D, Nirban RK, Kumar N, et al. Analysis of sociodemographic parameters of patients admitted in a newly established palliative care center in a regional cancer institute of North-West India. Indian J Palliat Care 2014;20:220-3.
- Chow E, Danjoux C, Wong R, Szumacher E, Franssen E, Fung K, et al. Palliation of bone metastases: A survey of patterns of practice among Canadian radiation oncologists. Radiother Oncol 2000;56:305-14.
- van Oorschot B, Schuler M, Simon A, Schleicher U, Geinitz H. Patterns of care and course of symptoms in palliative radiotherapy: A multicenter pilot study analysis. Strahlenther Onkol 2011;187:461-6.
- Westhoff PG, de Graeff A, Geerling JI, Reyners AK, van der Linden YM. Dexamethasone for the prevention of a pain flare after palliative radiotherapy for painful bone metastases: A multicenter double-blind placebo-controlled randomized trial. BMC Cancer 2014;14:347.
- Feyer PC, Steingraeber M. Radiotherapy of bone metastasis in breast cancer patients – Current approaches. Breast Care (Basel) 2012;7:108-12.
- Akhtar MS, Kousar F, Fatmi S, Jabeen K, Akhtar K. Quality of life and symptoms control in brain metastasis after palliative whole brain radiotherapy using two different protocols. J Coll Physicians Surg Pak 2012;22:311-6.
- Wong E, Hoskin P, Bedard G, Poon M, Zeng L, Lam H, et al. Re-irradiation for painful bone metastases – A systematic review. Radiother Oncol 2014;110:61-70.
- Chiu N, Chiu L, Popovic M, DeAngelis C, Lutz S, Zhang N, et al. Re-irradiation for painful bone metastases: Evidence-based approach. Ann Palliat Med 2015;4:214-9.
- Huisman M, van den Bosch MA, Wijlemans JW, van Vulpen M, van der Linden YM, Verkooijen HM, et al. Effectiveness of reirradiation for painful bone metastases: A systematic review and meta-analysis. Int J Radiat Oncol Biol Phys 2012;84:8-14.
- Souchon R, Wenz F, Sedlmayer F, Budach W, Dunst J, Feyer P, et al. DEGRO practice guidelines for palliative radiotherapy of metastatic breast cancer: Bone metastases and metastatic spinal cord compression (MSCC). Strahlenther Onkol 2009;185:417-24.