title: International practice survey on palliative lung radiotherapy: third international consensus workshop on palliative radiotherapy and symptom control.
abstract: BACKGROUND
  The purpose of this work was to disseminate international practice survey results created in conjunction with the Third International Lung Cancer Consensus Workshop.
  
  
  METHODS
  In conjunction with the American Society for Radiation Oncology (ASTRO) Guideline for Palliative Lung Cancer Care and International Workshop Consensus statements, an online international practice survey was conducted during the summer of 2010. The survey included demographic, educational, and clinical questions as well as 5 cases exploring the role of external beam radiotherapy, endobronchial brachytherapy, and concurrent chemoradiation.
  
  
  RESULTS
  A total of 279 individuals responded to the survey over a 3-month period. Most respondents were hospital-based, academic, or government-funded radiation oncologists. Factors that consistently related to use and choice of external beam dose fractionation included estimated treatment benefit to patient, performance status (PS), symptom severity, patient choice, estimated prognosis, and previous radiation to the same site. Factors consistently not related to use and dose fractionation included requirement for future radiation therapy, department policy, and waiting lists. A significant range of dose fractionation schedules existed for external beam (n = 35) and endobronchial brachytherapy treatment (n = 10). The integration of concurrent chemotherapy was recorded by a significant minority of respondents despite lack of level I evidence to support its use. Geographic differences in the use of external beam dose fractionation and of concurrent chemotherapy were seen.
  
  
  CONCLUSIONS
  Various patient, tumor, treatment, and logistic factors are associated with the variable use and external beam dose fractionation of palliative lung treatments. The copublication of the ASTRO Guideline for Palliative Lung Cancer Care and International Workshop Consensus statements should assist clinicians by providing evidence-based care.
authors.affiliation: Department of Radiation Oncology, University of Western Ontario, London Ontario, Canada. george.rodrigues@lhsc.on.ca
authors.forename: George
authors.initials: G
authors.lastname: Rodrigues
authors.forename: Fergus
authors.initials: F
authors.lastname: Macbeth
authors.forename: Bryan
authors.initials: B
authors.lastname: Burmeister
authors.forename: Karie-Lynn
authors.initials: KL
authors.lastname: Kelly
authors.forename: Andrea
authors.initials: A
authors.lastname: Bezjak
authors.forename: Corey
authors.initials: C
authors.lastname: Langer
authors.forename: Carol
authors.initials: C
authors.lastname: Hahn
authors.forename: Anushree
authors.initials: A
authors.lastname: Vichare
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
mesh_terms: D001918:Brachytherapy; D059186:Chemoradiotherapy, Adjuvant; D019317:Evidence-Based Medicine; D006801:Humans; D007391:International Cooperation; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D010166:Palliative Care / Q000592:standards*; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D017064:Process Assessment, Health Care; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States