Palliative Radiotherapy for Advanced Cancers

Williams, G.R.; Manjunath, Shwetha; Butala, Anish A.; Jones, Joshua

doi:10.1016/j.soc.2021.02.007

Cited by 10 publications

(9 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Palliative radiotherapy refers to the application of radiotherapy to the primary tumor and metastases of advanced malignant tumors to relieve pain, improve symptoms, and prolong life ( 111 ). Palliative radiotherapy for advanced GC patients is safe and effective.…”

Section: Palliative Radiotherapymentioning

confidence: 99%

Application and progress of palliative therapy in advanced gastric carcinomas

Luo

Luo²,

Zhao³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

Gastric carcinomas have high morbidity and mortality. It produces no noticeable symptoms in the early stage while causing complex complications in its advanced stage, making treatment difficult. Palliative therapy aims to relieve the symptoms of cancer patients and focuses on improving their quality of life. At present, five palliative therapies for advanced gastric carcinomas are offered: resection, gastrojejunostomy, stenting, chemotherapy, and radiotherapy. In recent years, palliative therapy has been used in the clinical treatment of advanced gastric carcinomas and related complications because of its efficacy in gastric outlet obstruction and gastric bleeding. In the future, multimodal and interdisciplinary palliative therapies can be applied to control general symptoms to improve patients’ condition, prolong their lifespan and improve their quality of life.

show abstract

Section: Palliative Radiotherapymentioning

confidence: 99%

Application and progress of palliative therapy in advanced gastric carcinomas

Luo

Luo²,

Zhao³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Palliative radiotherapy plays an important role in the multimodal management of patients with incurable cancer [1,2]. Goals of treatment (pain relief, tumor growth inhibition, prolongation of survival) vary and are influenced by several patient-and disease-related factors, e.g., patient preference, performance status (PS), overall tumor burden, availability and efficacy of systemic anticancer treatment, and size of the radiation target volume [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Palliative appropriateness criteria: external validation of a new method to evaluate the suitability of palliative radiotherapy fractionation

et al. 2023

View full text Add to dashboard Cite

Background Recently, the palliative appropriateness criteria (PAC) score, a novel metric to aid clinical decision-making between different palliative radiotherapy fractionation regimens, has been developed. It includes baseline parameters including but not limited to performance status. The researchers behind the PAC score analyzed the percent of remaining life (PRL) on treatment. The latter was accomplished by calculating the time between start and finish of palliative radiotherapy (minimum 1 day in case of a single-fraction regimen) and dividing it by overall survival in days from start of radiotherapy. The purpose of the present study was to validate this novel metric. Patients and methods The retrospective validation study included 219 patients (287 courses of palliative radiotherapy). The methods were identical to those employed in the score development study. The score was calculated by assigning 1 point each to several factors identified in the original study and using the online calculator provided by the PAC developers. Results Median survival was 6 months and death within 30 days from start of radiotherapy was recorded in 13% of courses. PRL on treatment ranged from 1 to 23%, median 8%. Significant associations were confirmed between online-calculated PAC score, observed survival, and risk of death within 30 days from the start of radiotherapy. Patients with score 0 had distinctly better survival than all other groups. The score-predicted median risk of death within 30 days from start of radiotherapy was 22% in our cohort. A statistically significant correlation was found between predicted and observed risk (p < 0.001). The original and present study were not perfectly concordant regarding number and type of baseline parameters that should be included when calculating the PAC score. Conclusion This study supports the dual strategy of PRL and risk of early death calculation, with results stratified for fractionation regimen, in line with the original PAC score study. When considering multifraction regimens, the PAC score identifies patients who may benefit from shorter courses. Additional work is needed to answer open questions surrounding the underlying components of the score, because the original and validation study were only partially aligned.

show abstract

“…RT is also indicated for pain, prevention of imminent metastatic complications, severe mass effect or neurological symptoms. Several small studies and reviews suggest an improvement of neurological symptoms and pain relief by RT in ACC [ 2 , 17 – 20 ] similar to other solid tumours [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma

et al. 2022

View full text Add to dashboard Cite

Background International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low. Methods We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000. Primary endpoint: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses. Results In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50–60 Gy (n = 20) or 20–49 Gy (n = 69), stereotactic body RT of 35–50 Gy (SBRT) (n = 36), or brachytherapy of 12–25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0–148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03–0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12–0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22–1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established. Conclusions This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.

show abstract

Palliative Radiotherapy for Advanced Cancers

Cited by 10 publications

References 74 publications

Application and progress of palliative therapy in advanced gastric carcinomas

Application and progress of palliative therapy in advanced gastric carcinomas

Palliative appropriateness criteria: external validation of a new method to evaluate the suitability of palliative radiotherapy fractionation

Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma

Contact Info

Product

Resources

About