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Palliative radiation therapy of lung cancer

General

Palliative radiation therapy is a useful first-choice treatment in patients with non-small cell lung carcinoma in stages III and IV, where a positive effect from systemic chemotherapy is unlikely. 

Symptoms in patients with small cell lung carcinoma are usually effectively relieved by chemotherapy. Patients with recurrence of small cell lung carcinoma, where additional chemotherapy is not considered beneficial, may obtain successful palliative results from radiation therapy.

Thoracic radiation

Locally advanced lung cancer may cause many different symptoms. Palliative radiation therapy is a relatively mild treatment and the majority of the patients are relieved of bothersome symptoms by this treatment. 

    
Symptoms

Subjective improvement reported by patients

Cough 50-70%
Hemoptysis 70-100%
Pain 50%
Dyspnea 20-40%
Vena cava superior syndrome 90-100%
Atelectasis 20-25%
Hoarseness 8-10%

Palliative radiation therapy is often given in fractions that optimize the therapeutic effect while minimizing unwanted side effects and with short treatment time. In this way, a high total dose is given to the tumor tissue while damage to the normal tissue is minimized.

When the treatment is given as palliation it is very important that the acute side effects are insignificant and of short duration.

Palliative radiation therapy is used for primary tumors, local recurrence, and metastasis.

Indications

  • Incurable lung cancer 
  • Symptomatic metastases

Goal

  • Relieve symptoms
  • Prevent new symptoms

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