A comparative study of different dose fractionations schedule of thoracic radiotherapy for pain palliation and health-related quality of life in metastatic NSCLC

Sau, Sourav; Sau, Saikat; Dutta, Puspendu; Gayen, Ganesh Chandra; Banerjee, Samir; Basu, Abhishek

doi:10.4103/0970-2113.142111

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…Same schedule of thoracic radiotherapy was used by Sau et al for pain palliation and health-related quality of life using FACT-G in non-small cell lung carcinoma patients but improvement in FACT-G score was statistically non-significant. 13 But statistically significant improvement in FACT-G Score in present study shows the promising role of adding gefitinib in the radiotherapy during palliative setting in adenocarcinoma lung patients. Impact of gefitinib concomitant with palliative radiotherapy as well as maintenance therapy with gefitinib in terms of adverse effects observed in the present study found that skin rashes were the most common toxicity, encountered in 59% of the patients.…”

mentioning

confidence: 48%

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Verma¹

2017

jmscr

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mentioning

confidence: 48%

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Verma¹

2017

jmscr

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“…Among the published trials, 116 trials (52%) used PROs. PROs were primary end points in 45 trials 20,26,28,30,[34][35][36][37]42,48,53,[56][57][58][61][62][63]66,70,74,75,77,79,83,85,93,94,97,103,[108][109][110]113,115,117,118,124,125,127,128,130,133,134,137 (20% of all published trials; 31% of 145 trials clearly stating their primary end point; 39% of 116 trials including a PRO) and secondary end points in 71 trials 24,25,27,29,[31][32][33]…”

Section: Resultsmentioning

confidence: 99%

“…Median (IQR) sample size was 98 (41-230) patients in trials with a PRO as a primary end point, and 50 (31-132) patients in trials with a PRO as a secondary end point. Metastases and thoracic primaries were the most common treated sites (eFigure 3 in the Supplement ), including in 37 published trials 26 , 28 , 30 , 34 , 35 , 36 , 37 , 42 , 48 , 53 , 57 , 61 , 63 , 70 , 74 , 75 , 77 , 79 , 83 , 85 , 93 , 94 , 103 , 108 , 109 , 110 , 113 , 115 , 117 , 118 , 123 , 124 , 125 , 126 , 128 , 133 , 137 (82%) with a PRO as a primary end point and in 50 published trials 27 , 29 , 31 , 32 , 33 , 38 , 39 , 40 , 41 , 43 , 44 , 46 , 51 , 54 , 55 , 65 , 67 , 68 ,…”

Section: Resultsmentioning

confidence: 99%

Use and Reporting of Patient-Reported Outcomes in Trials of Palliative Radiotherapy

et al. 2022

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ImportanceApproximately 50% of all patients with cancer have an indication for radiotherapy, and approximately 50% of radiotherapy is delivered with palliative intent, with the aim of alleviating symptoms. Symptoms are best assessed by patient-reported outcomes (PROs), yet their reliable interpretation requires adequate reporting in publications.ObjectiveTo investigate the use and reporting of PROs in clinical trials of palliative radiotherapy.Evidence ReviewThis preregistered systematic review searched PubMed/Medline, EMBASE, and the Cochrane Center Register of Controlled Trials for clinical trials of palliative radiotherapy published from 1990 to 2020. Key eligibility criteria were palliative setting, palliative radiotherapy as treatment modality, and clinical trial design (per National Institutes of Health definition). Two authors independently assessed eligibility. Trial characteristics were extracted and standard of PRO reporting was assessed in adherence to the Consolidated Standards of Reporting Trials (CONSORT) PRO extension. The association of the year of publication with the use of PROs was assessed by logistic regression. Factors associated with higher CONSORT-PRO adherence were analyzed by multiple regression. This study is reported following the PRISMA guidelines.FindingsAmong 7377 records screened, 225 published clinical trials representing 24 281 patients were eligible. Of these, 45 trials (20%) used a PRO as a primary end point and 71 trials (31%) used a PRO as a secondary end point. The most prevalent PRO measures were the Numeric Rating Scale/Visual Analogue Scale (38 trials), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (32 trials), and trial-specific unvalidated measures (25 trials). A more recent year of publication was significantly associated with a higher chance of PROs as a secondary end point (odds ratio [OR], 1.04 [95% CI, 1.00-1.07]; P = .03) but not as primary end point. Adherence to CONSORT-PRO was poor or moderate for most items. Mean (SD) adherence to the extension adherence score was 46.2% (19.6%) for trials with PROs as primary end point and 31.8% (19.8%) for trials with PROs as a secondary end point. PROs as a primary end point (regression coefficient, 9.755 [95% CI, 2.270-17.240]; P = .01), brachytherapy as radiotherapy modality (regression coefficient, 16.795 [95% CI, 5.840-27.751]; P = .003), and larger sample size (regression coefficient, 0.028 [95% CI, 0.006-0.049]; P = .01) were significantly associated with better PRO reporting per extension adherence score.Conclusions and RelevanceIn this systematic review of palliative radiotherapy trials, the use and reporting of PROs had room for improvement for future trials, preferably with PROs as a primary end point.

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“…This is similar to Rees et al [11] who also found that 17 Gy in 2 fractions, day 1 and 8 or 22.5 Gy in five daily fractions had no clinically important differences in efficacy between the two regimens. Similarly, Sourav et al [25] randomly assigned patients to three treatments arms: 1) 17 Gy in 2 fractions, day 1 and 8; 2) 20 Gy in five fractions in one week and 3) 30 Gy in 10 fractions in two weeks. Symptomatic relief was equivalent in all the three arms.…”

Section: Symptomatic Assessmentmentioning

confidence: 99%

A Prospective Study of the Effect of Different Palliative Radiotherapy Fractionation Schedules on Tumor Response and Toxicity in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients

Lotayef¹,

Elkader²,

Amin³

et al. 2016

JCT

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Background: The optimal dose of palliative radiotherapy (RT) in symptomatic advanced lung cancer is unclear. Patients and methods: Patients with advanced NSCLC who were indicated for thoracic palliative RT with age up to 65 y and Performance Status (PS) 0-2 and no significant cardiac or lung co-morbidities were randomized into two fractionation arms: arm A: 30 Gy/10 over 2 weeks and arm B: 27 Gy/6 over 3 weeks (2 fractions per week) using 2 anterior posterior (AP-PA) fields in both arms. Primary end points were symptomatic and radiological tumor response, respiratory functions assessment. Secondary end point was toxicity. Results: From December 2014 to October 2015, 40 patients were randomized, 20 patients in each arm. There was statistically insignificant higher symptomatic improvement in arm B. Four weeks after treatment, 12 out of 40 patients (30%), 6 patients in each arm, had radiological Partial Response (PR) of the primary thoracic lesion without significant difference between the two arms. There was a tendency for improvement in the post treatment mean Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) in each arm without statistical significance. There were no reported skin reactions or esophagitis in both arms up to 4 weeks after treatment. Eleven out of the 40 patients (27.5%), 6 in arm B and 5 in arm A, had radiological signs of radiation pneumonitis without significant difference between both arms. Conclusion: The two RT fractionation schedules showed equal efficacy in terms of symptoms relief, radiological response of the primary thoracic tumor, respiratory functions and toxicity. Thus the 27 Gy/6 fractionation arm appears preferable compared to 30 Gy/10 arm to minimize the patients' visits and load on the machines.

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A comparative study of different dose fractionations schedule of thoracic radiotherapy for pain palliation and health-related quality of life in metastatic NSCLC

Cited by 7 publications

References 16 publications

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Use and Reporting of Patient-Reported Outcomes in Trials of Palliative Radiotherapy

A Prospective Study of the Effect of Different Palliative Radiotherapy Fractionation Schedules on Tumor Response and Toxicity in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients

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