Immediate or delayed radiotherapy in advanced non-small-cell lung cancer (NSCLC)? Data from a prospective randomised study.

S. Sundstrøm, R. Bremnes, P. Brunsvig, U. Aasebø, O. Klepp, Peter Fayers, S. Kaasa, Norwegian Lung Cancer Study Group

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29 Citations (Scopus)

Abstract

Background and purpose: To compare the course of symptoms and health-related quality-of-life (HRQOL) after immediate thoracic radiotherapy (TRT) between symptomatic (S) and non-symptomatic (NS) patients with advanced NSCLC.

Patients and methods: 407 stage III/IV patients were initially treated with immediate TRT within a randomised phase III trial comparing different fractionation schedules. At inclusion, patients were prospectively stratified according to presence (S) or absence (NS) of tumour-related chest/airway symptoms to facilitate comparison between these groups. The EORTC QLQ-C30 and LC-13 were used for symptom and HRQOL assessments at baseline and at regular intervals up to 1 year (N = 395).

Results: NS patients had significantly more favourable baseline characteristics when compared to S patients with a median survival of 11.8 versus 6.0 months (P < 0.0001), respectively. At baseline, S patients demonstrated HRQOL scores inferior to those of NS patients (P < 0.01) for most scales. Until week 14, NS patients developed more symptoms while S patients experienced symptom relief in most scales. After week 14, no significant differences could be observed between the groups.

Conclusion: This study indicates that immediate TRT, given to patients with minimal/none chest symptoms, does not prevent development of disease-related symptoms and diminished HRQOL. A wait-and-see policy appears to be acceptable. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)141-148
Number of pages8
JournalRadiotherapy and Oncology
Volume75
Issue number2
Early online date11 May 2005
DOIs
Publication statusPublished - May 2005

Bibliographical note

Acknowledgements
This study was initiated and performed by The Norwegian Lung Cancer Study Group. The secretarial assistance at the Clinical Research Office, The University Hospital of Trondheim is greatly appreciated

Keywords

  • palliative radiotherapy
  • lung cancer
  • NSCLC
  • immediate treatment
  • quality-of-life
  • QUALITY-OF-LIFE
  • PALLIATIVE THORACIC RADIOTHERAPY
  • QUESTIONNAIRE QLQ-C30
  • ASYMPTOMATIC PATIENTS
  • INOPERABLE CARCINOMA
  • CLINICAL-TRIALS
  • SCORES
  • YES
  • NO

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