Aim : To compare the effect of two RT schedules for thoracic palliation in advanced NSCLC patients (30 Gy in 10 fractions over two weeks and 27 Gy in 6 fractions over three weeks, 2 fractions per week) on pulmonary symptoms, radiological response of the primary thoracic tumour and pulmonary functions.
Material and method: A hospital based quantitative prospective follow-up study. Total 104 advanced NSCLC patients were randomized into two fractionation arms. Evaluation was done pretreatment and 4 weeks after end of RT. Symptom palliation and radiological response to RT was assessed by using RTOG 4-point scale and Revised (RECIST) guideline version 1.1 respectively. Radiotherapy was given by cobalt-60 teletherapy machine.
Results: Total 96 patients were evaluated for symptom palliation, radiological response and acute toxicities. The percentage of patients achieving symptom palliation (namely cough chest pain, dyspnea or hemoptysis) was slightly higher in the control arm. At 1st month of follow-up, 16.67% & 18.75% patients in Study & control arm showed PR. Post-RT mean FVC and FEV1 showed a tendency for improvement in both mean FVC and FEV1 in compare to baseline. Treatment was well tolerated both arms. The difference in symptom palliation, radiological response and pulmonary functions in both arms was not statistically significant.
Conclusion: The two RT fractionation schedules showed equal efficacy in terms of symptoms relief, radiological response of the primary thoracic tumor and pulmonary functions. Thus the 27 Gy/6 fractionation arm appears preferable compared to 30 Gy/10 arm to minimize the patients’ visits and load on the machines.
Impact Factor
2022: 6.012
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