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Published online by Cambridge University Press: 04 August 2010
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.
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