Background: 30-day mortality (30DM) has been suggested as a clinical indicator of the avoidance of harm in palliative radiotherapy within the NHS, but no large-scale population-based studies exist. This large retrospective cohort study aims to investigate the factors that influence 30DM following palliative radiotherapy and consider its value as a clinical indicator.Methods: All radiotherapy episodes delivered in a large UK cancer centre between January 2004 and April 2011 were analysed. Patterns of palliative radiotherapy, 30DM and the variables affecting 30DM were assessed. The impact of these variables was assessed using logistic regression.Results: 14,972 palliative episodes were analysed. 6334 (42.3%) treatments were delivered to bone metastases, 2356 (15 7%) to the chest for lung cancer and 915 (5.7%) to the brain. Median treatment time was 1 day (IQR 1–7). Overall 30DM was 12.3%. Factors having a significant impact upon 30DM were sex, primary diagnosis, treatment site and fractionation schedule (p < 0.01).Conclusion: This is the first large-scale description of 30-day mortality for unselected adult palliative radiotherapy treatments. The observed differences in early mortality by fractionation support the use of this measure in assessing clinical decision making in palliative radiotherapy and require further study in other centres and health care systems.

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Fifty two cases of squamous cell carcinoma were studied using indium-111 labelled Bleomycin. The overall accuracy of localization by static imaging alone was 80%. Detection of lung and gynaecological tumours was most consistent, while oesophageal tumours were the most commonly missed. Imaging within a few hours of administration of the radiopharmaceutical was found to be as effective as imaging at the recommended time of at least 24 hours. Inflammatory lesions giving false positive scans could be differentiated from tumour tissue by the technique of dynamic imaging. Maximum activity occurred in tumour tissue on average ten minutes after the peak for normal tissue. This difference was used to improve the detection of known tumours to 90%.