Reasons for Palliative Treatments in Stage III Non-Small-Cell Lung Cancer: What Contribution Is Made by Time-Dependent Changes in Tumour or Patient Status?

Robinson, Andrew; Young, Kelvin; Balchin, Katelyn; Owen, Timothy; Ashworth, A.

doi:10.3747/co.22.2689

Cited by 11 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One recent Canadian study found that approximately one-half of this population is not treated curatively, with weight loss and performance status heavily affecting treatment intent. 14,15 It is beyond the scope of this guideline update to define curability for stage III NSCLC, but knowing that these patients are frequently treated with palliative intent, we view RCT data on how this treatment should be delivered as valuable. Ultimately, we leave it to the discretion of the prescribing physicians to determine parameters for curability, acknowledging that poor PS, weight loss, and inability to achieve dosimetric goals likely provide the best guidance.…”

Section: Narrativementioning

confidence: 99%

Palliative thoracic radiation therapy for non-small cell lung cancer: 2018 Update of an American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

Moeller

Balagamwala

Chen

et al. 2018

Practical Radiation Oncology

View full text Add to dashboard Cite

show abstract

Section: Narrativementioning

confidence: 99%

Palliative thoracic radiation therapy for non-small cell lung cancer: 2018 Update of an American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

Moeller

Balagamwala

Chen

et al. 2018

Practical Radiation Oncology

View full text Add to dashboard Cite

show abstract

“…A significant proportion of locally-advanced non-small cell lung cancer (NSCLC) patients are ineligible for standard of care radical treatment. Recommendations suggest 6-7 weeks of concurrent chemoradiotherapy [1,2], but due to competing comorbidities, logistic issues associated with daily attendance over many weeks and the toxic nature of treatment, almost half of patients do not receive curative treatment [3][4][5] and up to 21% receive no treatment whatsoever [6,7]. The situation was similar for early-stage NSCLC patients until the advent of stereotactic body radiotherapy (SBRT).…”

Section: Introductionmentioning

confidence: 99%

Contrast enhanced oesophageal avoidance for stereotactic body radiotherapy: Barium vs. Gastrografin

Woodford

Panettieri

Ruben

et al. 2019

Technical Innovations & Patient Support in Radiation Oncolo

View full text Add to dashboard Cite

Introduction: SABR may facilitate treatment in a greater proportion of locally-advanced NSCLC patients, just as it has for early-stage disease. The oesophagus is one of the key dose-limiting organs and visualization during IGRT would better ensure toxicity is avoided. As the oesophagus is poorly seen on CBCT, we assessed the extent to which this is improved using two oral contrast agents. Materials & methods: Six patients receiving radiotherapy for Stage I-III NSCLC were assigned to receive 50 mL Gastrografin or 50 mL barium sulphate prior to simulation and pre-treatment CBCTs. Three additional patients who did not receive contrast were included as a control group. Oesophageal visibility was determined by assessing concordance between six experienced observers in contouring the organ. 36 datasets and 216 contours were analysed. A STAPLE contour was created and compared to each individual contour. Descriptive statistics were used and a Kappa statistic, Dice Coefficient and Hausdorff distance were calculated and compared using a t-test. Contrast-induced artefact was assessed by observer scoring. Results: Both contrast agents significantly improved the consistency of oesophagus localisation on CBCT across all comparison metrics compared to CBCTs without contrast. Barium performed significantly better than Gastrografin with improved kappa statistics (p = 0.007), dice coefficients (p < 0.001) and Hausdorff distances (p = 0.002), although at a cost of increased image artefact. Discussion: Barium produced lower delineation uncertainties but more image artefact, compared to Gastrografin and no contrast. It is feasible to use oral contrast as a tool in IGRT to help guide clinicians and therapists with online matching and monitoring of the oesophageal position.

show abstract

“…Thereby, the median age of the patients in our series was 61.23 years in the literature younger than in Robinson and Shamsi series with a median age of 68 years and 70 years respectively[22 -81]; collaborator found an average age of 68 years in Ontario[3] and found an average age of 70 years[4].The reasons for the palliative treatment of lung cancer in our center were essentially due essentially to dosimetric constraints: large tumor volume; localization close to the spinal cord marrow and the deterioration of performance status (>2) and pulmonary function of our patients. Thus, these reasons are comparable to those found by Sundstrom and collaborators in a study involving 421 patients with locally advanced stage III or IV lung tumors treated by palliative radiotherapy, who included patients with disease too advanced for inoperable curative radiotherapy, those with chest symptoms due to a central tumor threatening the airways[5].…”

mentioning

confidence: 52%

Palliative Treatment of Locally Advanced Non Metastatic Lung Cancer

Kietga¹,

Mosse²,

Agbanglanon³

et al. 2021

JCT

View full text Add to dashboard Cite

Introduction: To determine the proportion and the reasons which lead to palliative treatment in patients initially a candidate for concomitant chemoradiotherapy (CCRT). Methods: A retrospective study including patients followed for locally advanced lung cancer newly diagnosed from April 1, 2016, to 12/31/2017 in the radiotherapy department of the National Oncology Institute who received palliative treatment. Results: We collected 52 patients out of a total of 225 stage III patients (23%) followed by lung cancer candidates for CCRT who had undergone palliative treatment. The mean age in our series was 61.23 years [22-81] with 86% male. The majority of patients (71%) had Performance Status (PS) ≤ 2. Histological confirmation was obtained by pathological examination in all our patients. It was an adenocarcinoma (ADK) in 54% of cases; squamous cell carcinoma in 46% of cases. The reasons for palliative treatment were mainly due to dosimetric constraints: large tumor volume 22/52 (42%); the tumor location close to the bone marrow in 15 of 52 (29%) patients; and general Performance Status impairment (29%) in 15 of 52 patients. Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients (71%), among whom 19 (51%) were stable after 2 months of chemotherapy, in palliative dose chest radiotherapy on the pulmonary parenchyma and/or mediastinum in 10 of 52 (19%) patients, and supportive care in 5 (10 %) patients. We observed 40/52 (77%) cases of stationary course, 04/52 (8%) cases of progress to metastases, and 08/52 (15%) deaths before radiotherapy. Conclusion: A large proportion of patients followed for locally advanced non-metastatic lung cancer are not eligible for curative treatment. The reasons for the palliative treatment of patients followed for lung cancer candidates for CCRT are variable but for a large proportion of patients due to the deterioration of their state of health during their diagnostic journey. Hence, there

show abstract

Reasons for Palliative Treatments in Stage III Non-Small-Cell Lung Cancer: What Contribution Is Made by Time-Dependent Changes in Tumour or Patient Status?

Abstract: IntroductionStage iii lung cancer is the most advanced stage of lung cancer for which the potential of curative

Cited by 11 publications

References 12 publications

Palliative thoracic radiation therapy for non-small cell lung cancer: 2018 Update of an American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

Palliative thoracic radiation therapy for non-small cell lung cancer: 2018 Update of an American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

Contrast enhanced oesophageal avoidance for stereotactic body radiotherapy: Barium vs. Gastrografin

Palliative Treatment of Locally Advanced Non Metastatic Lung Cancer

Contact Info

Product

Resources

About