A palliative accelerated irradiation regimen for advanced non-small-cell lung cancer vs. conventionally fractionated 60 GY: results of a randomized equivalence study

PURPOSE: Radiation oncologists are often faced with patients with advanced non-small-cell lung cancer (NSCLC), who are not suitable candidates for state-of-the-art radical treatment, but who also are not judged to have a very short life expectancy. Some physicians treat these patients palliatively,...

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Hauptverfasser: Nestle, Ursula (VerfasserIn) , Nieder, C. (VerfasserIn) , Walter, K. (VerfasserIn) , Abel, Ulrich (VerfasserIn) , Ukena, D. (VerfasserIn) , Sybrecht, G. W. (VerfasserIn) , Schnabel, K. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2000
In: International journal of radiation oncology, biology, physics
Year: 2000, Jahrgang: 48, Heft: 1, Pages: 95-103
ISSN:1879-355X
DOI:10.1016/s0360-3016(00)00607-6
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/s0360-3016(00)00607-6
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Verfasserangaben:Ursula Nestle, Carsten Nieder, Karin Walter, Ulrich Abel, Dieter Ukena, Gerhard W. Sybrecht and Klaus Schnabel

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520 |a PURPOSE: Radiation oncologists are often faced with patients with advanced non-small-cell lung cancer (NSCLC), who are not suitable candidates for state-of-the-art radical treatment, but who also are not judged to have a very short life expectancy. Some physicians treat these patients palliatively, whereas others advocate more intensive treatment. To find out if there is a substantial difference in outcome between these approaches, we performed a randomized prospective study. METHODS AND MATERIALS: Between 1994 and 1998, 152 eligible patients with advanced NSCLC Stage III (n = 121) or minimal Stage IV (n = 31) were randomized to receive conventionally fractionated (cf; A: 60 Gy, 6 weeks, n = 79) or short-term treatment (PAIR; B: 32 Gy, 2 Gy b.i.d.; n = 73) of tumor and mediastinum. RESULTS: One-year survival rate for all patients was 37% with no significant difference between the two treatment arms (A: 36%; B: 38%; p = 0.76). As far as can be judged from limited data available, palliation was adequate and similar for the two treatment arms. Apart from expected differences in the time course of esophagitis, acute side effects were moderate and equally distributed. No severe late effects were observed. CONCLUSIONS: In the present randomized trial, survival and available data on palliation were not different after cf to 60 Gy compared to the palliative PAIR regimen. Therefore, for patients who are not suitable for radical treatment approaches, the prescription of a palliative short-term irradiation appears preferable compared to cf over several weeks. 
650 4 |a Adenocarcinoma 
650 4 |a Adult 
650 4 |a Aged 
650 4 |a Aged, 80 and over 
650 4 |a Analysis of Variance 
650 4 |a Carcinoma, Non-Small-Cell Lung 
650 4 |a Carcinoma, Squamous Cell 
650 4 |a Dose Fractionation, Radiation 
650 4 |a Esophagitis 
650 4 |a Female 
650 4 |a Humans 
650 4 |a Karnofsky Performance Status 
650 4 |a Lung Neoplasms 
650 4 |a Male 
650 4 |a Middle Aged 
650 4 |a Neoplasm Staging 
650 4 |a Palliative Care 
650 4 |a Prospective Studies 
650 4 |a Radiation Pneumonitis 
650 4 |a Regression Analysis 
650 4 |a Survival Rate 
650 4 |a Time Factors 
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700 1 |a Walter, K.  |e VerfasserIn  |4 aut 
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700 1 |a Sybrecht, G. W.  |e VerfasserIn  |4 aut 
700 1 |a Schnabel, K.  |e VerfasserIn  |4 aut 
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