Impact of Radiation Dose on the Survival of Patients With Non-small Cell Lung Cancer Treated With Palliative Intent: Results of a Multicenter Prospective Study

Anticancer Res. 2024 Dec;44(12):5477-5484. doi: 10.21873/anticanres.17373.

Abstract

Background/aim: Many patients with non-small cell lung cancer (NSCLC) receive palliative radiotherapy (RT). Several factors were analyzed to aid in prescribing an optimal treatment for these patients.

Patients and methods: This prospective observational multicenter study investigated several potential factors for associations with overall survival (OS) in 61 patients with NSCLC receiving palliative RT with or without chemotherapy (CT). Investigated factors included age, sex, performance status, history of smoking or alcohol, hemoglobin, co-morbidities, different clinical symptoms, and quality-of-life aspects.

Results: Median OS was 10.8 months, and OS rates at 6, 12, and 24 months were 58.5%, 42.5%, and 28.4%, respectively. On multivariate analysis, RT alone (without CT), RT doses ≤30 Gy, advanced tumor stage (stage IV), and poor emotional functioning at diagnosis were associated with significantly worse OS.

Conclusion: Patients with NSCLC assigned to palliative RT may benefit from RT doses >30 Gy and additional CT. Sequential CT appears preferable, since concurrent CT increases esophageal toxicity.

Keywords: Non-small cell lung cancer; overall survival; palliative radiotherapy; prognostic factors; prospective study.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung* / mortality
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Carcinoma, Non-Small-Cell Lung* / radiotherapy
  • Female
  • Humans
  • Lung Neoplasms* / mortality
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / radiotherapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Palliative Care* / methods
  • Prospective Studies
  • Quality of Life
  • Radiotherapy Dosage