Radiothérapie du cancer bronchique non à petites cellules de stade III, inopérable, asymptomatique. Résultats définitifs d'un essai prospectif randomisé (240 patients)

Palliative thoracic radiotherapy in non-small cell lung cancer. An analysis of 1250 patients. Palliation of symptoms, tolerance and toxicity

“…The treatment of choice for patients ineligible for palliative chemotherapy is palliative thoracic radiotherapy (PTR) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The aim of PTR is to achieve optimal control of symptoms, limit treatment duration and, if possible, avoid patients' hospitalization.…”

“…What is the tolerance and toxicity of PTR in this particular group of patients with short expected survival? The opinions on these subjects in the literature are conflicting [1,[3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Palliative percutaneous radiotherapy in non-small-cell lung cancer

“…However, median survival and 1-year overall survival plotted versus (uncorrected) total dose of radiotherapy ( Figures 1A,C) suggest the existence of a dose-effect relationship, which is even more obvious for 1-year overall survival (R 2 = 0.52) compared to median survival (R 2 = 0.44). Whereas a significant survival benefit for higher radiation doses has been reported from only three studies [6][7][8], non-significant survival advantages have been observed in one additional study looking at median survival and in five additional studies considering 1-year overall survival ( Table 2). A significant decrease in median and overall survival was observed in none of the studies, and a nonsignificant decrease in only two out of 10 studies.…”

“…One might be tempted to conclude that in the palliative setting, even in patients with good performance status, no dose response exists at doses above 45 Gy. However, Reinfuss et al [8] have reported a significantly longer survival duration following 50 Gy (conventional fractionation) compared to 40 Gy split-course irradiation (4.0 Gy single doses). No patient with distant disease was included in this study, whereas in the study of Nestle et al [10], in which no survival benefit was seen at the higher dose level (32 Gy vs. 60 Gy), 21% of the patients had already clear evidence of distant disease at the time of study entry.…”

Radiotherapy for non-small cell lung cancer. Current knowledge, future modalities

“…La chimio-radiothé rapie concomitante est le traitement standard des cancers bronchiques localement avancé s irradiation thoracique exclusive, qui, comparé e aux soins palliatifs dans deux é tudes randomisé es [30,35], permettait une survie à 2 ans de 18 % (versus 0 % sous soins palliatifs). En outre, par rapport à la chimiothé rapie exclusive, l'essai de Kubota et coll.…”