Palliative radiotherapy in patients with a poor performance status: the palliative effect is correlated with prolongation of the survival time

Radiation Oncology

Yukunori Korogi³  Hajime Imada²  Hiroyuki Narisada²  Katsuya Yahara¹  Yuichi Matsuki³  Takayuki Ohguri¹  Shinsaku Yamaguchi³ 

[1] Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan;Department of Cancer therapy center, Tobata Kyoritsu Hospital, Kitakyushu, Japan;Department of Radiology, Kitakyushu General Hospital, Kitakyushu, Japan

关键词: Support team assessment schedule;    Symptomatic relief;    Palliative radiotherapy;   

Others  :  1153554
DOI  :  10.1186/1748-717X-8-166

 received in 2013-03-28, accepted in 2013-06-28,  发布年份 2013

【 摘 要 】

Background

The purpose of this study was to analyze the efficacy and tolerability of palliative radiotherapy (RT) in patients with a poor performance status (PS) and to evaluate the relationship between the palliative effect and survival time.

Methods

One hundred and thirty-three patients with a poor PS (Eastern Cooperative Oncology Group 3 or 4) were treated with palliative RT using the three-dimensional conformal technique and retrospectively analyzed. Each patient's primary symptom treated with palliative RT as the major cause of the poor PS was evaluated using the second item of the Support Team Assessment Schedule (STAS) at the start and one week after the completion of palliative RT.

Results

One hundred and fourteen (86%) of the 133 patients completed the planned palliative radiation dose. Grade 3 acute toxicity was observed in two patients (2%) and Grade 2 acute toxicity was observed in 10 patients (9%). No Grade 2 or higher late toxicities were observed, except for Grade 3 radiation pneumonitis in one patient. Improvement in the STAS scores between pre- and post-palliative RT was recorded in 76 (61%) of the 125 patients with available scores of STAS. A significant improvement in the mean STAS score between pre- and post-palliative RT was recognized (p < 0.0001). Improvement in the STAS score was found to be the most statistically significant prognostic factor for overall survival after palliative RT in both the multivariate and univariate analyses. The median overall survival time in the patients with an improvement in the STAS score was 6.4 months, while that in the patients without improvement was 2.4 months (p < 0.0005).

Conclusions

Palliative RT in patients with a poor PS provides symptomatic benefits in more than half of patients without inducing severe toxicities. The palliative effect is strongly correlated with prolongation of the survival time and may contribute to improving the remaining survival time in patients with metastatic/advanced cancer with a poor PS.

【 授权许可】

   
2013 Yamaguchi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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