Radiation therapy inadequate for many patients with end-stage cancer

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Patients with terminal cancer need better radiation therapy, according to an analysis published in Cancer (2010 Apr 12 [Epub ahead of print]).

In a study to investigate the benefit of palliative radiotherapy in end-stage cancer patients, Stephan Gripp, MD, of the University Hospital Duesseldorf in Germany, and colleagues evaluated the treatment of patients who died within 30 day after being referred for palliative radiotherapy.

Researcher found that 91% of the patients were treated with radiotherapy. Half of the patients spent more than 60% of their remaining days on radiotherapy, and in only 58% of patients was radiotherapy completed. Further findings revealed that about 1 in 5 physicians predicted survival greater than 6 months; 52% of patients reported progressive complaints , and only 26% of them reported reduced pain.

According to the press release announcing the findings, the authors concluded that radiotherapy was not appropriately customized to these cancer patients, many of whom did not benefit despite spending most of their remaining life on therapy. In addition, the authors stated that excessive radiotherapy in end-stage cancer patients may reflect overoptimistic prognoses and unrealistic concerns about radiation damage. In the report, Dr. Gripp recommended that physicians use shorter-duration radiation schedules for palliative radiotherapy.

“Radiation oncologists have fallen short in accurately determining the life span of terminally ill cancer patients. This has resulted in unduly prolonged radiation therapy regimens that often go uncompleted due to death or withdrawal from treatment,” said Dr. Gripp. “Physicians need batter methods for estimating how long their end-stage cancer patients will live.”

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