Palliative Radiation Use for Lung Cancer Higher Than Advised

In metastatic lung cancer patients, bone and chest radiotherapy doses higher than recommended

FRIDAY, Jan. 18 (HealthDay News) -- Half of patients with metastatic non-small-cell lung cancer (NSCLC) receive at least one course of palliative radiation therapy (RT), with younger patients and those who received chemotherapy or surgery more likely to receive palliative RT, according to a study published online Jan. 7 in the Journal of Clinical Oncology.

Aileen B. Chen, M.D., M.P.P., from the Dana-Farber Cancer Institute in Boston, and colleagues investigated population-based patterns in the use of palliative RT among a cohort of 1,574 patients with metastatic NSCLC, diagnosed from 2003 to 2005, using data from the Cancer Care Outcomes Research and Surveillance Consortium study.

The researchers found that 50 percent of the patients received at least one course of RT, 21 percent received RT to the chest, and 12 percent to the bone. Younger age at diagnosis and receipt of chemotherapy and surgery to metastatic sites were factors associated with the use of palliative RT. Six percent of patients receiving palliative bone RT received single-fraction treatment, while 42 percent of those receiving palliative chest RT received more than 20 fractions. Lower doses and fewer fractions to the bone and chest were more likely among patients treated in integrated networks.

"When palliative RT is used in patients with metastatic NSCLC, a substantial proportion of patients receive a greater number of treatments and higher doses than supported by current evidence, suggesting an opportunity to improve care delivery," Chen and colleagues conclude.

One author disclosed financial ties to WellPoint.

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