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

Nestle, Ursula; Nieder, Carsten; Walter, Karin; Abel, Ulrich; Ukena, D.; Sybrecht, Gerhard W.; Schnabel, K.

doi:10.1016/s0360-3016(00)00607-6

Cited by 79 publications

(45 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The issue of optimal palliative irradiation schedule in symptomatic NSCLC has been a subject of numerous prospective randomised studies (Table 6) (Medical Research Council Lung Cancer Working Party, 1991;Medical Research Council Lung Cancer Working Party, 1992;Simpson et al, 1985;Teo et al, 1988;Abratt et al, 1995;Macbeth et al, 1996;Rees et al, 1997;Reinfuss et al, 1999;Nestle et al, 2000;Gaze et al, 2001;Bezjak et al, 2002;Kramer et al, 2003;Sundstrom et al, 2004). Although the comparison of these trials is difficult due to differences in the radiotherapy regimens, patient characteristics and outcome measures, there is no strong evidence for the superiority of any particular regimen (Hansen, 2002;Macbeth et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, shorter treatments generally allow hospitalisation to be avoided and enable earlier improvement of symptoms (Kowalska, 1992). The equivalence of shorter vs longer radiotherapy schemes in terms of symptom control was demonstrated in a series of randomised studies (Simpson et al, 1985;Medical Research Council Lung Cancer Working Party, 1991;Medical Research Council Lung Cancer Working Party, 1992;Abratt et al, 1995;Nestle et al, 2000;Kramer et al, 2003;Sundstrom et al, 2004). Nevertheless, doubts still exist regarding the potentially detrimental impact of shorter regimens on overall survival, particularly in patients with good performance status.…”

mentioning

confidence: 99%

See 1 more Smart Citation

A prospective, randomised study to compare two palliative radiotherapy schedules for non-small-cell lung cancer (NSCLC)

et al. 2005

View full text Add to dashboard Cite

A prospective randomised study compared two palliative radiotherapy schedules for inoperable symptomatic non-small-cell lung cancer (NSCLC). After stratification, 100 patients were randomly assigned to 20 Gy/5 fractions (fr)/5 days (arm A) or 16 Gy/2 fr/day 1 and 8 (arm B). There were 90 men and 10 women aged 47 -81 years (mean 66), performance status 1 -4 (median 2). The major clinical characteristics and incidence and degree of initial disease-related symptoms were similar in both groups. Treatment effects were assessed using patient's chart, doctor's scoring of symptomatic change and chest X-ray. Study end points included degree and duration of symptomatic relief, treatment side effects, objective response rates and overall survival. A total of 55 patients were assigned to arm A and 45 to arm B. In all, 98 patients received assigned treatment, whereas two patients died before its termination. Treatment tolerance was good and did not differ between study arms. No significant differences between study arms were observed in the degree of relief of all analysed symptoms. Overall survival time differed significantly in favour of arm B (median 8.0 vs 5.3 months; P ¼ 0.016). Both irradiation schedules provided comparable, effective palliation of tumour-related symptoms. The improved overall survival and treatment convenience of 2-fraction schedule suggest its usefulness in the routine management of symptomatic inoperable NSCLC.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A prospective, randomised study to compare two palliative radiotherapy schedules for non-small-cell lung cancer (NSCLC)

et al. 2005

View full text Add to dashboard Cite

show abstract

“…There have been 14 published randomized clinical trials evaluating the optimal hypofractionation regimen to palliate symptoms of advanced NSCLC, which are considerably less resource and time intensive [1,2,[5][6][7][8][9][10][11][12][13][14][15][16]. However there is still no consensus on which fractionation scheme should be used.…”

Section: Introductionmentioning

confidence: 99%

Palliative Hypofractionated Radiotherapy in South Egyptian Patients with Stage III and IV Non-Small Cell Lung Cancer

Attia¹

2015

JCPCR

View full text Add to dashboard Cite

Background: In patients with advanced non-small cell lung cancer the priority should be given to controlling symptoms of the disease and thoracic radiotherapy remains an important treatment modality for these patients. The use of shorter radiotherapy schedules has an economic and logistic advantage for radiotherapy departments, as well as a high degree of patient convenience. However there is still no consensus on which fractionation scheme should be used.The aim of the study is to evaluate the effect of hypofractionated regimen (36Gy/12 fractions versus 17Gy/2 weekly fractions regimen) on symptoms relief, assessment of treatment related toxicity and its impact on overall survival (OS) in patients with locally advanced stage III and stage IV non-small cell lung cancer (NSCLC). Patients and methods:Patients were randomly assigned into two treatment groups: 1, receive 36 Gy per 12 fractions and group 2, receive 17 Gy per two fractions. Assessments by clinician for improvement of symptoms and toxicity were done weekly during radiotherapy, one month, 3 months and every 3 months thereafter. Symptomatic response was assessed by comparing the initial score for each symptom with the best score during follow-up period. A total symptom score (TSS) was produced for each patient, by adding the scores of each individual symptom. Results:The total symptom scores before radiotherapy was significantly higher to that after radiotherapy (Wilcoxon signed-rank test Z=-6.434, P=.0001). The degree and duration of symptom relief were equivalent in the treatment groups. There were no reported cases of grade 3 or 4 esophagitis or pulmonary toxicity. Grade 2 acute esophagitis was greater among patients received 36 Gy/ 12 fractions compared to those received 17 Gy/ 2 fractions (26.3% vs 14%, P = .177) but did not reach statistical significance. Two patients (3.5%) experienced grade 2 acute pneumonitis. No significant difference in survival among treatment groups was found (one year OS for group 1, was 22.3% and for group 2, was 20.4%, P = .434).Conclusion: 17Gy/2 weekly fractions regimen, provide good symptomatic relief with comparable survival to 36Gy/12 fractions regimen and should be used for patients requesting a shorter treatment course especially in which palliative chemotherapy is planned.

show abstract

“…Several studies have explored radiotherapy for primary tumor sites in patients with advanced lung cancer, and the results suggested that it was able to improve the local control rate, relieve the symptoms, and improve the survival rate. However, this benefit was mainly restricted to patients with good performance status and to those with metastases or single metastasis of limited volume (Nestle et al, 2000;Bezjak et al, 2002;Reinfuss et al, 2011;Hasselle et al, 2012). In addition, long radiotherapy intervals, long-term adverse effects, and the high costs confine the application of radiotherapy as well.…”

Section: Discussionmentioning

confidence: 99%

Effects of microwave ablation or its combination with whole-body chemotherapy on serum vascular endothelial growth factor levels in patients with stage IIIB/IV NSCLC

Sun¹,

Py²,

Guo³

et al. 2015

Genet. Mol. Res.

View full text Add to dashboard Cite

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

Cited by 79 publications

References 24 publications

A prospective, randomised study to compare two palliative radiotherapy schedules for non-small-cell lung cancer (NSCLC)

A prospective, randomised study to compare two palliative radiotherapy schedules for non-small-cell lung cancer (NSCLC)

Palliative Hypofractionated Radiotherapy in South Egyptian Patients with Stage III and IV Non-Small Cell Lung Cancer

Effects of microwave ablation or its combination with whole-body chemotherapy on serum vascular endothelial growth factor levels in patients with stage IIIB/IV NSCLC

Contact Info

Product

Resources

About