Palliative radiotherapy
Short courses of radiation, often a single treatment, to relieve pain from bone metastases, stop bleeding, open blocked airways or protect the spinal cord. Among the most cost-effective treatments in cancer.
About 40% of radiotherapy courses are palliative. Trials established that a single 8 Gy fraction equals multi-fraction regimens for uncomplicated bone metastases (RTOG 9701, Dutch Bone Metastasis Study; ~60% pain response), that 8 Gy ×1 or 20 Gy ×5 suffices for spinal cord compression in poor-prognosis patients (SCORAD III, ICORG), and that whole-brain radiotherapy adds little for poor-performance NSCLC brain metastases (QUARTZ) while SRS replaces it for limited metastases. Other indications: haemostasis (bladder, gynaecologic, lung), airway and oesophageal obstruction, SVC syndrome, hepatic pain, skin fungation. Underuse of single fractions persists in fee-for-service systems; rapid-access palliative clinics shorten time to treatment.
How it works
Deliver a biologically sufficient dose for symptom control with minimum visits and toxicity, using simple techniques (parallel-opposed or 3D) or SBRT where oligometastatic ablation is intended.
- Single fraction as good as multiple for bone pain
- Fast, cheap, widely available
- Effective for bleeding, obstruction, cord compression
- Underuse of single fractions and overuse of long courses
- Pain flare in ~30%
- Retreatment limits with prior high doses
Latest papers
topQuery for this technology: (TITLE:"Palliative radiotherapy" OR ABSTRACT:"Palliative radiotherapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Palliative radiotherapy, not a curated reading list.