NEW YORK (Reuters Health), Aug 9 - Short-course split-dose radiotherapy helps relieve the symptoms of advanced non-small cell lung cancer (NSCLC), Polish oncologists report.
They based their conclusion on a retrospective study of 1,250 patients. All of the patients were ineligible for palliative chemotherapy because of poor performance status, weight loss, comorbidities, or old age. Instead the patients themselves opted for two series of 20 Gy in five fractions each, four weeks apart, targeted at the primary tumor with a 2-cm margin of normal tissue in the mediastinum.
In a July 31 online paper in Lung Cancer, Dr. Marian Reinfuss and colleagues at the Center of Oncology--Maria Sklodowska-Curie Memorial Institute, Krakow, report that 638 patients (51%) had some palliative effect from the treatment, and 25.1% had resolution of symptoms. Specifically, response rates were 54.1% in patients with cough, 68% in patients with hemoptysis, 51.1% in those with thoracic pain, 38.3% in those with dyspnea, 12% of those who had hoarseness, and 8% in patients with dysphagia.
Ninety-two percent of patients could tolerate two courses of treatment at the planned dose and time. One hundred patients did not undergo the second course of radiation for various reasons; however, it was discontinued for toxicity in only 12 patients, and only 14 patients actively chose to discontinue.
Nonetheless, all the treated patients developed radiation esophagitis, and 22% had nausea. Most recovered from esophagitis within two to four weeks after the first course, and by five to six weeks after the second course.
The median survival from the day the patient was scheduled for palliative radiotherapy was 6.5 months. All had died within 36 months.
The authors conclude that the protocol is safe and effective for patients with advanced NSCLC who are not eligible for palliative chemotherapy.
They add, "Low costs, low frequency of hospitalization, good patient compliance, and a good therapeutic index favor hypofractionated regimens against longer schedules in patients with poor performance status."
Source: http://link.reuters.com/rus93n
Lung Cancer 2010.
Last Updated: 2010-08-09 11:15:21 -0400 (Reuters Health)
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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
