Short course accelerated radiation therapy (SHARON) in palliative treatment of advanced solid cancer in older patients: A pooled analysis

J Geriatr Oncol. 2018 Jul;9(4):359-361. doi: 10.1016/j.jgo.2018.01.004. Epub 2018 Feb 15.

Abstract

Objectives: To evaluate the efficacy and safety of a conformal Short Course Accelerated Radiation therapy (SHARON) for symptomatic palliation of locally advanced or metastatic cancers in older patients.

Materials and methods: This is a pooled analysis on patients aged ≥80 years selected between subjects enrolled in 3 phase I-II studies on a short course palliative treatment of advanced or metastatic cancer. The primary endpoint was to evaluate the symptoms response rate produced by accelerated radiotherapy delivered in 4 total fractions in twice a day. Total dose ranged between 14 Gy and 20 Gy while dose/fraction between 3.5 and 5 Gy.

Results: A total of 48 patients were included in this analysis. Twenty-six patients (54.2%) had advanced primary or metastatic head and neck tumors, 11 (22.9%) locally advanced or metastatic thoracic cancers, 11 (22.9%) complicated bone metastases. The majority of patients presented pain (60.4%). With a median follow-up time of 5.5 months, no G4 acute and late toxicities were recorded. The overall palliative response rate was 91.7% with a median duration of palliation of 4 months.

Conclusion: Short course accelerated radiotherapy in locally advanced or metastatic cancers is effective in terms of symptom relief and well tolerated even in older patients.

Keywords: Older patients; Pain; Palliative care; Quality of life; Radiotherapy.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Aged, 80 and over
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / radiotherapy*
  • Bone Neoplasms / secondary
  • Dose Fractionation, Radiation
  • Female
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / secondary
  • Humans
  • Male
  • Pain Management / methods
  • Palliative Care / methods*
  • Thoracic Neoplasms / diagnostic imaging
  • Thoracic Neoplasms / radiotherapy*
  • Thoracic Neoplasms / secondary
  • Tomography, X-Ray Computed
  • Treatment Outcome