Abstract
Background: To investigate the prevalence of indications for radiotherapy (RT) in patients with metastatic/recurrent/inoperable cancer. We also sought to analyze such patients’ clinical and radiological characteristics for indications of radiotherapy in those patients who had either surveillance or an initial assessment done by computed tomography (CT). Methods: Two diagnostic radiologists and a radiation oncologist evaluated a total of 13,225 consecutive patients from January 2012 to December 2012 at a single Japanese institution. Patients with metastatic/recurrent/ inoperable cancer were selected for further study. After two diagnostic radiologists identified patients with a detectable cancerous lesion, a radiation oncologist subsequently investigated whether there was any indication for RT. The oncologist also evaluated the relationship between patients’ clinical/radiological factors, and patients with or without indications for RT. Results: Two diagnostic radiologists selected 329 patients showing a detectable gross cancerous lesion. In this patient group, a radiation oncologist identified 196 patients with metastatic/recurrent/inoperable cancer, of which 96 patients (49%) showed an indication for RT. According to both univariate and multivariate analyses, ≤4 lesions were significantly associated with patients who showed an indication for RT (P = 0.0002 and P 0.001, respectively). Conclusions: In screening CT images, approximately half of all patients with metastatic/recurrent/inoperable cancer showed an indication for RT. Moreover, ≤4 lesions and/or the existence of a symptomatic, localized lesion were highly suggestive of an indication for RT. These findings would be of considerable interest to radiation oncologists planning appropriate treatments for cancer patients.
Highlights
Radiotherapy (RT) is an essential and well-established treatment, used in the management of many types of malignancies, and plays a major role in a curative, adjuvant setting, as well as in palliation [1]-[5]
In screening computed tomography (CT) images, approximately half of all patients with metastatic/recurrent/inoperable cancer showed an indication for RT
For patients with metastatic/recurrent cancer according to the Response Evaluation Criteria in Solid Tumors (RECIST) [10] [11], assessing the antitumor effects of systemic therapy using an image modality is important in order to estimate the efficacy of therapies, and is a key to guide potential changes in treatment
Summary
Radiotherapy (RT) is an essential and well-established treatment, used in the management of many types of malignancies, and plays a major role in a curative, adjuvant setting, as well as in palliation [1]-[5]. For patients with metastatic/recurrent cancer according to the Response Evaluation Criteria in Solid Tumors (RECIST) [10] [11], assessing the antitumor effects of systemic therapy using an image modality (mainly CT) is important in order to estimate the efficacy of therapies, and is a key to guide potential changes in treatment. To investigate the prevalence of indications for radiotherapy (RT) in patients with metastatic/recurrent/inoperable cancer. We sought to analyze such patients’ clinical and radiological characteristics for indications of radiotherapy in those patients who had either surveillance or an initial assessment done by computed tomography (CT). After two diagnostic radiologists identified patients with a detectable cancerous lesion, a radiation oncologist subsequently investigated whether there was any indication for RT. Results: Two diagnostic radiologists selected 329 patients showing a detectable gross cancerous lesion.
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