P3-181: Palliative radiotherapy in locally advanced non small cell lung cancer

Abstract

The treatment of choice for patients with inoperable, locally too extensive non-small cell lung cancer (NSCLC) is radiotherapy with the aim of palliation thoracic symptoms. There is no strong evidence that any regimen gives greater palliation and least toxicity, but the typical standard schedule in many Institutions is 30Gy in 10 fractions over two weeks. To investigate, whether the shorter course of 20Gy in 5 fractions over one week is comparable to standard schedule for symptom control and survival. A total of 67 patients with symptomatic inoperable locally advanced non small cell lung cancer were included. 30 patients (arms A) received 30Gy in 10 fractions over two weeks and 37 patients (arms B) with 20Gy in 5 fractions over one week. All patients were treated through antero-posteriorly opposing portal in Linear accelerator. The field included the loco regional tumour volume with margin of not more 1cm. The major clinical characteristics and the incidence and degree of initial disease related symptoms in both groups were similar. 85% patients had dyspnoea 59, 7% cough, 44, 7% haemoptysis and 34, 3% chest pain. Treatment effects were assessed using scoring of symptomatic changes and by chest X-Ray or CT. No significant differences between study arms were observed in the degree of relief of cough, dyspnoea, chest pain, and haemoptysis. Palliation of symptoms was achieved in high rates in both group of patients: 78, 2% for pain (80% A / 77% B), 76, 6% for haemoptysis (78,5A / 75% B), 35% for dyspnoea (34, 6%A / 35, 4%B), and 40 % for cough (38, 8%A /40, 9%B). There were no differences between two arms in survival. Treatment was well tolerated in both arms. The most frequent adverse event was oesophagitis grade 2. The short regimen of 20Gy in five fractions provide equivalent survival and effective palliation of tumour related symptoms in the patients with symptomatic inoperable locally advanced non small cell lung cancer The short regimen had social and economic advantages compared with standard regimen and suggest its usefulness in the routine management