PALLIATIVE RADIOTHERAPY (PT) AS A CANCER TREATMENT: A REVIEW

Main Article Content

. SHALLU
NEERAJ PANDEY

Abstract

Radiotherapy (RT) is essential to the diagnosis of oncological emergencies, including cord compression or brain metastasis neurological damage, airway restricting and bleeding. Palliative radiation treatment offers a quick, economical and effective way to decrease many of the focal symptoms of advanced, incurable illness, whether from main tumor or metastatic deposits. Evidence shows that approximately 10 percent of patients who died of cancer at their end of life received palliative RT. It can enhance the quality of life while being linked to a restricted burden of therapy in terms of both hospital attendance and side effects. An approximately 20% to 50% of radiation classes are prescribed with palliative intent because radiation therapy is extremely efficient in relieving symptoms, and palliative dose toxicity is typically mild. Palliative radiation therapy plays a vital role, particularly in the midst of the ongoing COVID-19 pandemic, in avoiding severe morbidity in patients with metastatic cancer in setting oncological emergencies. This article seeks to update non-specialists on the advantages, practicalities, and side effects of palliative radiotherapy to guarantee patients are regarded and referred for these medicines when necessary.

Keywords:
Palliative, radiation therapy, tumor, metastatic deposits, symptoms

Article Details

How to Cite
SHALLU, ., & PANDEY, N. (2020). PALLIATIVE RADIOTHERAPY (PT) AS A CANCER TREATMENT: A REVIEW. Asian Journal of Research in Biology, 3(1), 8-14. Retrieved from https://ikprress.org/index.php/AJRiB/article/view/5098
Section
Review Papers

References

Jones J. A brief history of palliative radiation oncology. In: S. Lutz, E. Chow and P. Hoskin eds.: Radiation Oncology in Palliative Cancer Care. West Sussex: Wiley-Blackwell; 2013.

World Health Organization. WHO definition of palliative care.
Available:www.who.int/cancer/palliative/painladder/en/

Lutz Stephen, Korytko, Timothy, Nguyen, Janet Khan, Luluel, Chow, Edward, Corn, Benjamin. Palliative radiation therapy: When is it worth it and when is it not? Cancer Journal. 2010;16 (5):473-482.

Robert EC. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clinical Cancer Research. 2006;12(20):6243s-6249s.

Spencer K, Morris E, Dugdale E, et al. 30 day mortality in Adult palliative radiotherapy—a retrospective population based study of 14,972 treatment episodes. Radiotherapy and Oncology. 2015;115(2):264-271.

Roos DE, Turner SL, O’Brien PC, et al. Randomized trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05). Radiotherapy and Oncology. 2005;75(1):54-63.

World Health Organization. WHO’s cancer pain ladder for adults; 2018.
Available:www.who.int/cancer/palliative/painladder/en/

Kane CM, Hoskin P, Bennett MI. Cancer induced bone pain. The BMJ; 2015.

Koswig S, Budach V. Remineralization and pain relief in bone metastases after after different radiotherapy fractions (10 times 3 Gy vs. 1 time 8 Gy). A prospective study. Strahlenther Onkol Organ Dtsch Rontgengesellschaft Al (Europe PMC). 1999;175(10):500-508.

Townsend PW, Smalley SR, Cozad SC, Rosenthal HG, Hassanein RE. Role of postoperative radiation therapy after stabilization of fractures caused by metastatic disease. International Journal of Radiation Oncology Biology Physics. 1995;31(1):43- 99.

Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures. Clinical Orthopaedics and Related Research (Europe PMC). 1989;249:256-264.

Chow E, Zeng L, Salvo N, Dennis K, Tsao M, Lutz S. Update on the systematic review of palliative radiotherapy trials for bone metastases. Clinical Oncology. 2012;24(2):112-124.

Sze WM, Shelley M, Held I, Mason M. Palliation of metastatic bone pain: single fraction versus multi fraction radiotherapy - A systematic review of the randomised trials. Cochrane Database Systematic Reviews (Clinical Oncology); 2004.

Chow E, van der Linden YM, Roos D, et al. Single versus multiple fractions of repeat radiation for painful bone metastases: A randomised, controlled, non-inferiority trial. The Lancet Oncolology. 2014; 15(2):164-71.

Walters S, Maringe C, Coleman MP, et al. ICBP Module 1 Working Group, Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: A population-based study, 2004-2007. Thorax. 2013;68(6):551-564.

Cancer Research UK. Lung cancer incidence statistics; 2015.
Available:www.cancerresearchuk.org
/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/incidence

Sundstrøm S, Bremnes R, Aasebø U, et al. Hypofractionated palliative radiotherapy (17 Gy per two fractions) in advanced non-small-cell lung carcinoma is comparable to standard fractionation for symptom control and survival: A national phase III trial. Journal of Clinical Oncology. 2004;22:801-810.

Kassam Z, Wong RKS, Ringash J, et al. A phase I/II study to evaluate the toxicity and efficacy of accelerated fractionation radiotherapy for the palliation of dysphagia from carcinoma of the oesophagus. Clinical Oncology (R Coll Radiol). 2008;20(1):53-60.

Dai Y, Li C, Xie Y, et al. Interventions for dysphagia in oesophageal cancer. Cochrane Database of Systematic Reviews; 2014.

Javed A, Pal S, Dash NR, et al. Palliative stenting with or without radiotherapy for inoperable esophageal carcinoma: A randomized trial. Journal of Gastrointest Cancer. 2012;43(1):63-69.

Rosenblatt E, Jones G, Sur RK, et al. Adding external beam to intra-luminal brachytherapy improves palliation in obstructive squamous cell oesophageal cancer: a prospective multi-centre randomized trial of the international atomic energy agency. Radiotherapy and Oncolgy. 2010;97(3):488-494.

Stevens R, Macbeth F, Toy E, Coles B, Lester JF. Palliative radiotherapy regimens for patients with thoracic symptoms from non-small cell lung cancer. Cochrane Database of Systematic Reviews; 2015.

Fairchild K, Harris E, Barnes, et al. Palliative thoracic radiotherapy for lung cancer: A systematic review. Journal of Clinical Oncology. 2008;26:4001-4011.

Byrne TN. Spinal cord compression from epidural metastases. The New England Journal of Medicine. 1992;327(9):614-619.

National Institute for Health and Care Excellence. Metastatic spinal cord compression in adults (quality standard QS56).
Available:www.nice.org.uk/guidance/qs56

George R, Jeba J, Ramkumar G, Chacko AG, Tharyan P. Interventions for the treatment of metastatic extramural spinal cord compression in adults. Cochrane Database of Systematic Reviews; 2015.

Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 2005;30(19):2186-2191.

Rades D, Douglas S, Veninga T, et al. Validation and simplification of a score predicting survival in patients irradiated for metastatic spinal cord compression. Cancer. 2010;116(15):3670-3673.

Rades D, Šegedin B, Conde-Moreno AJ, et al. Radiotherapy with 4 Gy × 5 Versus 3 Gy × 10 for metastatic epidural spinal cord compression: Final results of the SCORE-2 trial (ARO 2009/01). Journal of Clinicl Oncology. 2016;34:597-602.

Maranzano E, Bellavita R, Rossi R, et al. Short-course versus split-course radiotherapy in metastatic spinal cord compression: results of a phase III, randomized, multicenter trial. Journal of Clinical Oncology. 2005;23:3358-3365.

Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: A randomised trial. The Lancet. 2005;366(9486): 643-648.

Rades D, Douglas S, Huttenlocher S, et al. Validation of a score predicting post-treatment ambulatory status after radiotherapy for metastatic spinal cord compression. Inter-national Journal of Radiation Oncology Biology Physics. 2011;79(5):1503-1506.

Royal College of Radiologists. Radiotherapy dose fractionation. 2nd ed; 2016.
Available:www.rcr.ac.uk/system/files/
publication/field_publication_files/bfco163_
dose_fractionation_2nd_ed_march2017.pdf

Kirkpatrick JP, van der Kogel AJ, Schultheiss TE. Radiation dose-volume effects in the spinal cord. International Journal of Radiation Oncology Biology Physics. 2010;76(3):S42-S49.

Tsao MN, Lloyd N, Wong RK, et al. Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database of Systematic Reviews; 2012.

Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. International Journal of Radiation Oncology Biology Physics. 1997;37(4):745-751.

Sperduto PW, Berkey B, Gaspar LE, Mehta M, Curran W. A new prognostic index and comparison to three other indices for patients with brain metastases: An analysis of 1,960 patients in the RTOG database. International Journal of Radiation Oncology Biology Physics. 2008;70(2):510-514.

Linskey ME, Andrews DW, Asher AL, et al. The role of stereotactic radio surgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. Journal of Neuro-oncology. 2010;96(1):45-68.

Kalkanis SN, Kondziolka D, Gaspar LE, et al. The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. Journal of Neuro-oncology. 2010;96(1):33-43.

Patil CG, Pricola K, Sarmiento JM, Garg SK, Bryant A, Black KL. Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases. Cochrane Database of Systematic Reviews; 2012.

Mulvenna P, Nankivell M, Barton R, et al. Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non- inferiority, randomised trial. The Lancet. 2016;388(10055):2004-2014.

Kancherla KN, Oksuz DC, Prestwich RJD, et al. The role of split-course hypo fractionated palliative radiotherapy in head and neck cancer. Clinical Oncology. 2007;23(2):141-148.

Porceddu SV, Rosser B, Burmeister BH, et al. Hypofractionated radiotherapy for the palliation of advanced head and neck cancer in patients unsuitable for curative treatment—“Hypo Trial”. Radiotherapy and Oncology. 2011;85(3):456-462.

Corry J, Peters LJ, Costa ID, et al. The ‘QUAD SHOT’—a phase II study of palliative radiotherapy for incurable head and neck cancer. Radiotherapy and Oncology. 2005;77(2):137-142.

Duchesne GM, Bolger JJ, Griffiths GO, et al. A randomized trial of hypo fractionated schedules of palliative radiotherapy in the management of bladder carcinoma: Results of medical research council trial BA09. International Journal of Radiation Oncology Biology Physics. 2000;47(2):379-388.

Cameron MG, Kersten C, Vistad I, et al. Palliative pelvic radiotherapy for symptomatic rectal cancer—A prospective multicenter study. Acta Oncology. 2016;55:1400-1407.

Cameron MG, Kersten C, Guren MG, Fosså SD, Vistad I. Palliative pelvic radiotherapy of symptomatic incurable prostate cancer—A systematic review,” Radiotherapy and Oncology. 2014;110(1):55-60.

Yan J, Milosevic M, Fyles A, Manchul L, Kelly V, Levin W. A hypo fractionated radiotherapy regimen (0-7-21) for advanced gynaecological cancer patients,” Clinical Oncology (R Coll Radiol). 2011;23(7):476-481.

Barnes EA, Breen D, Culleton S, et al. Palliative radiotherapy for non-melanoma skin cancer. Clinical and Oncology (R Coll Radiol). 2010;22(10):844-849.

Wong CYB, Helm MA, Helm TN, Zeitouni N. Patterns of skin metastases: A review of 25 years’ experience at a single cancer center. International Journal of Dermatology. 2014;53:56-60.

Spratt DE, Gordon Spratt EA, Wu S, et al. Efficacy of skin-directed therapy for cutaneous metastases from advanced cancer: a meta-analysis. Journal of Clinical Oncology. 2014;32(28):3144-3155.

Adderley UJ, Holt IG. Topical agents and dressings for fun gating wounds. Cochrane Database of Systematic Reviews; 2014.

Hellman S, Weichselbaum RR. Oligometastases. Journal of Clinical Oncology. 1995;13:8-10.

Van der Velden JM, Verkooijen HM, Seravalli E, et al. Comparing conventional radio therapy with stereotact IC body radiotherapy in patients with spinal metastases: Study protocol for an randomized controlled trial following the cohort multiple randomized controlled trial design. BMC Cancer. 2016;16:909.

Braam P, Lambin P, Bussink J. Stereotactic versus conventional radiotherapy for pain reduction and quality of life in spinal metastases: Study protocol for a randomized controlled trial. Trials. 2016;17:61.

ClinicalTrials.gov. Study comparing stereotactic body radiotherapy vs conventional palliative radiotherapy (CRT) for spinal metastases.
Available:https://clinicaltrials.gov/ct2/show/NCT02512965

De Sa E, Sinclair E, Mitera G, et al. Continued success of the rapid response radiotherapy program: A review of 2004-2008. Support Care Cancer. 2009;17:757-762.