Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- PART I General concepts in oncology
- 1 Principles of diagnosis and staging
- 2 Principles of palliative chemotherapy
- 3 Principles of palliative surgery
- 4 Radiotherapy for palliation of symptoms
- 5 ABCs of clinical trials
- 6 Principles of cancer rehabilitation
- 7 Principles of palliative nursing
- 8 Ethics of decision making towards the end of life
- 9 Breaking bad news
- 10 The use of complementary/alternative medicine
- 11 Understanding “hospice”
- 12 Practical aspects of home care
- 13 Cultural differences in advanced cancer care
- 14 Implementing social services
- 15 Pastoral care
- 16 Bereavement
- Part II Primary tumors
- Part III Management of specific symptoms and syndromes
- Index
- References
4 - Radiotherapy for palliation of symptoms
Published online by Cambridge University Press: 04 August 2010
Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgements
- PART I General concepts in oncology
- 1 Principles of diagnosis and staging
- 2 Principles of palliative chemotherapy
- 3 Principles of palliative surgery
- 4 Radiotherapy for palliation of symptoms
- 5 ABCs of clinical trials
- 6 Principles of cancer rehabilitation
- 7 Principles of palliative nursing
- 8 Ethics of decision making towards the end of life
- 9 Breaking bad news
- 10 The use of complementary/alternative medicine
- 11 Understanding “hospice”
- 12 Practical aspects of home care
- 13 Cultural differences in advanced cancer care
- 14 Implementing social services
- 15 Pastoral care
- 16 Bereavement
- Part II Primary tumors
- Part III Management of specific symptoms and syndromes
- Index
- References
Summary
Principles of palliative radiation therapy
Between 30 and 50% of the patients who reach the service of radiotherapy are treated with radiotherapy with palliative intention. Palliative radiotherapy aims at an improvement or elimination of symptoms that are due to an incurable cancer, and it is effective in 75% of the cases. A treatment of palliative radiotherapy must relieve rapidly and for a long time, must interfere as little as possible with the general state of the patient and his or her way of living, and must lack, as much as possible, important secondary effects.
In some cases, besides aiming at relieving the symptoms, radiotherapy (RT) aspires to increase survival, even though there may not exist a clear increment in the usual cure rates. Such is the case, for instance, in glioblastoma multiforme, lung cancer in stage IIIB, and cervical cancer in stage IVA. In these cases, radiation is carried out as if the objective were curative (high doses, standard fractionation) even if the possibilities for a cure are remote. Thus, the difference between a radical approach and a palliative one is difficult to determine. Even in patients whose disease is disseminated, palliative radiotherapy must be conditioned to the concrete characteristics of each case, avoiding quick or easy treatments that do not consider the benefits of other approaches more suitable for the patient and his/her life expectations.
- Type
- Chapter
- Information
- Handbook of Advanced Cancer Care , pp. 27 - 39Publisher: Cambridge University PressPrint publication year: 2003
References
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Bone Pain Trial Working Party. 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomised comparison with a multifraction schedule over 12 months of patient follow-up. Radiother Oncol 1999;52:111–21CrossRef
A randomized trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases. Clin Oncol R Coll Radiol 1989;1:59–62CrossRefGoogle ScholarPubMed
, Radioterapia en el tratamiento del dolor canceroso. Revisiones en Cáncer 1992;1149–56Google Scholar
, , Hemibody irradiation for metastatic bone pain in two histologically distinct groups of patients. Clin Oncol 1989;1:67–9CrossRefGoogle ScholarPubMed
, Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline. J Clin Oncol 1998;16:1613–24CrossRefGoogle Scholar
, , . A comparison of misonidazole sensitized radiation therapy to radiation therapy alone for the palliation of hepatic metastases: results of a RTOG randomized prospective trial. Int J Radiat Oncol Biol Phys 1987;13:1057–64CrossRefGoogle ScholarPubMed
McQuay H J, Collins S L, Carroll D, Moore R A. Radiotherapy for the palliation of painful bone metastases (Cochrane Review). In The Cochrane Library 1, 2001. Oxford: Update Software
, , . Rapid course radiation therapy vs. more standard treatment: a randomized trial for bone metastases. Int J Radiat Oncol Biol Phys 1996;36:1085–9CrossRefGoogle ScholarPubMed
, , . Sr89 for treating pain from metastatic bone disease. Am J Health Syst Pharm 1995;52:2189–95Google Scholar
, , , , Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases. Radiother Oncol 1988;13:99–104CrossRefGoogle ScholarPubMed
, , , , Stereotactic radiosurgery: a review and comparison of methods. J Clin Oncol 1994;12:1085–99CrossRefGoogle ScholarPubMed
Price P, Yarnold J R, Easton D, Austin D, Palmer S G. Randomised comparison of single and multifraction radiotherapy schedules in the treatment of painful bone metastases. 3rd European Conference on Clinical Oncology and Cancer Nursing, 1985, p. 63. Stockholm, Sweden
, , . Irradiation of bone metastases in breast cancer patients: a randomized study with 1 year follow-up. Radiother Oncol 1995;34:179–84CrossRefGoogle ScholarPubMed
Bone metastasis: review and critical analysis of random allocation trials of local field treatment. Int J Radiat Oncol Biol Phys 1999;44:1–18CrossRefGoogle ScholarPubMed
Current status of systemic intravenous radiopharmaceuticals for the treatment of painful metastatic bone disease. Int J Radiat Oncol Biol Phys 1994;30:1187Google ScholarPubMed
, , The effect of a single fraction compared to multiple fractions on painful bone metastases: a global analysis of the Dutch Bone Metastasis Study. Radiother Oncol 1999;52:101–9CrossRefGoogle ScholarPubMed
, , The palliation of symptomatic osseous metastases: final results of the study by the Radiation Therapy Oncology Group. Cancer 1982;50:893–93.0.CO;2-Y>CrossRefGoogle Scholar
Whole brain radiotherapy in the treatment of metastatic brain tumors. Semin Surg Oncol 1998;14:64–93.0.CO;2-0>CrossRefGoogle ScholarPubMed
, on behalf of the Bone Pain Trial Group. Bone Pain Trial: a prospective randomised trial comparing a single dose of 8 Gy and a multifraction radiotherapy schedule in the treatment of metastasic bone pain. Br J Cancer 1998;78(Suppl. 2):6Google Scholar
, Fractionation and outcomes with palliative radiation therapy. Semin Radiat Oncol 2000;10:191–9CrossRefGoogle ScholarPubMed
Chenal C. Irradiations palliatives. In Radiothérapie Oncologiquer, ed. J P LeBourgeois, J Chavaudra, F Eschwege, pp. 519–24. Paris; Hermann editeurs des sciences et des arts, 1992
Radiotherapy for palliation of symptoms in incurable cancer. Curr Problems Cancer 1997;1:218–63Google Scholar
Hoskin P J. Radiotherapy in symptom management. In Oxford Textbook of Palliative Medicine, ed. D Doyle, G W Hanks, N MacDonald. Oxford: Oxford University Press 1993:117–29
, The final report of the expert panel for the radiation oncology bone metastasis work group of the American College of Radiology. Int J Radiat Oncol Biol Phys 1998;40:1117–24CrossRefGoogle Scholar
Radiotherapy for the palliation of painful bone metastases (Cochrane Review) http://www.update-software.com/abstracts/ab001793.htm
Center Watch: Clinical Trials in Bone Metastases http://www.centerwatch.com/patient/studies/cat348.html
Samarium SM–153 in bone pain http://www.quadranet.com
Reanalysis of the RTOG study of the palliation of symptomatic osseous metastasis. Cancer 1985;55:1468–723.0.CO;2-M>CrossRefGoogle ScholarPubMed
Bone Pain Trial Working Party. 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomised comparison with a multifraction schedule over 12 months of patient follow-up. Radiother Oncol 1999;52:111–21CrossRef
A randomized trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases. Clin Oncol R Coll Radiol 1989;1:59–62CrossRefGoogle ScholarPubMed
, Radioterapia en el tratamiento del dolor canceroso. Revisiones en Cáncer 1992;1149–56Google Scholar
, , Hemibody irradiation for metastatic bone pain in two histologically distinct groups of patients. Clin Oncol 1989;1:67–9CrossRefGoogle ScholarPubMed
, Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline. J Clin Oncol 1998;16:1613–24CrossRefGoogle Scholar
, , . A comparison of misonidazole sensitized radiation therapy to radiation therapy alone for the palliation of hepatic metastases: results of a RTOG randomized prospective trial. Int J Radiat Oncol Biol Phys 1987;13:1057–64CrossRefGoogle ScholarPubMed
McQuay H J, Collins S L, Carroll D, Moore R A. Radiotherapy for the palliation of painful bone metastases (Cochrane Review). In The Cochrane Library 1, 2001. Oxford: Update Software
, , . Rapid course radiation therapy vs. more standard treatment: a randomized trial for bone metastases. Int J Radiat Oncol Biol Phys 1996;36:1085–9CrossRefGoogle ScholarPubMed
, , . Sr89 for treating pain from metastatic bone disease. Am J Health Syst Pharm 1995;52:2189–95Google Scholar
, , , , Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases. Radiother Oncol 1988;13:99–104CrossRefGoogle ScholarPubMed
, , , , Stereotactic radiosurgery: a review and comparison of methods. J Clin Oncol 1994;12:1085–99CrossRefGoogle ScholarPubMed
Price P, Yarnold J R, Easton D, Austin D, Palmer S G. Randomised comparison of single and multifraction radiotherapy schedules in the treatment of painful bone metastases. 3rd European Conference on Clinical Oncology and Cancer Nursing, 1985, p. 63. Stockholm, Sweden
, , . Irradiation of bone metastases in breast cancer patients: a randomized study with 1 year follow-up. Radiother Oncol 1995;34:179–84CrossRefGoogle ScholarPubMed
Bone metastasis: review and critical analysis of random allocation trials of local field treatment. Int J Radiat Oncol Biol Phys 1999;44:1–18CrossRefGoogle ScholarPubMed
Current status of systemic intravenous radiopharmaceuticals for the treatment of painful metastatic bone disease. Int J Radiat Oncol Biol Phys 1994;30:1187Google ScholarPubMed
, , The effect of a single fraction compared to multiple fractions on painful bone metastases: a global analysis of the Dutch Bone Metastasis Study. Radiother Oncol 1999;52:101–9CrossRefGoogle ScholarPubMed
, , The palliation of symptomatic osseous metastases: final results of the study by the Radiation Therapy Oncology Group. Cancer 1982;50:893–93.0.CO;2-Y>CrossRefGoogle Scholar
Whole brain radiotherapy in the treatment of metastatic brain tumors. Semin Surg Oncol 1998;14:64–93.0.CO;2-0>CrossRefGoogle ScholarPubMed
, on behalf of the Bone Pain Trial Group. Bone Pain Trial: a prospective randomised trial comparing a single dose of 8 Gy and a multifraction radiotherapy schedule in the treatment of metastasic bone pain. Br J Cancer 1998;78(Suppl. 2):6Google Scholar
, Fractionation and outcomes with palliative radiation therapy. Semin Radiat Oncol 2000;10:191–9CrossRefGoogle ScholarPubMed
Chenal C. Irradiations palliatives. In Radiothérapie Oncologiquer, ed. J P LeBourgeois, J Chavaudra, F Eschwege, pp. 519–24. Paris; Hermann editeurs des sciences et des arts, 1992
Radiotherapy for palliation of symptoms in incurable cancer. Curr Problems Cancer 1997;1:218–63Google Scholar
Hoskin P J. Radiotherapy in symptom management. In Oxford Textbook of Palliative Medicine, ed. D Doyle, G W Hanks, N MacDonald. Oxford: Oxford University Press 1993:117–29
, The final report of the expert panel for the radiation oncology bone metastasis work group of the American College of Radiology. Int J Radiat Oncol Biol Phys 1998;40:1117–24CrossRefGoogle Scholar
Radiotherapy for the palliation of painful bone metastases (Cochrane Review) http://www.update-software.com/abstracts/ab001793.htm
Center Watch: Clinical Trials in Bone Metastases http://www.centerwatch.com/patient/studies/cat348.html
Samarium SM–153 in bone pain http://www.quadranet.com
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