Long-term survival in patients with NSCLC treated with single fraction vs multi-fraction palliative radiotherapy in the case of lung tumor, brain metastases, and bone metastases.

Abstract

e20082 Background: Patients with advanced non-small cell lung cancer (NSCLC) are candidates for different types of treatment, including chemotherapy and radiotherapy or supportive care. Despite the fatal prognosis in advanced disease, many experienced radiation oncologists will apply radiation at low doses with the intention of palliative care. Choosing an effective radiation dose that does not cause significant complications remains under discussion. Methods: We used an extensive database of medical patients diagnosed with NSCLC, treated with palliative radiotherapy at the Oncology Centre in Bydgoszcz, Poland, from June 1998 to December 2013. A group of 3202 patients was divided into subgroups: A) 1762 patients irradiated on the lung tumor (without distant metastases): Total dose: A1) 6 Gy/1 fr.(n = 19); A2) 8 Gy/1 fr.(n = 276); A3) 20 Gy/5 fr.(n = 1349); A4) 30 Gy/10 fr.(n = 118). B) 548 patients irradiated on the central nervous system (CNS) metastases: B1) 20 Gy/5 fr.(n = 476); B2) 30 Gy/10 fr.(n = 72). C) 892 patients irradiated on the bone metastases: C1) 8 Gy/1 fr.(n = 452); C2) 10 Gy/1 fr.(n = 30); C3) 20 Gy/5 fr.(n = 341); C4) 30 Gy/10 fr.(n = 69). Date of death was obtained from medical records. Patients who were alive or whose date of death could not be determined were censored at the date of their last encounter. Survival was calculated from the start of treatment to the date of death or censorship. Results: Overall Survival (in months) for each group was: A1) = 6; A2) = 5; A3) = 7; A4) = 7. B1) = 4; B2) = 4. C1) = 5; C2) = 4; C3) = 4; C4) = 5. There was no significant difference in survival between patients treated with single fraction pRT or multi-fractionation schedules in all groups of patients. Conclusions: The patients who were prescribed single fraction palliative radiotherapy did not have poorer prognoses or experience shorter survival than patients who were prescribed multi-fraction pRT in the case of lung tumor, brain metastases and bone metastases.