title: Palliative thoracic radiotherapy for patients with advanced non-small cell lung cancer and poor performance status.
abstract: OBJECTIVE
  The evaluation of efficacy of palliative thoracic radiotherapy (PTR) in patients with advanced non-small cell lung cancer (NSCLC) and to compare it with efficacy of supportive care (SC) alone.
  
  
  METHODS
  Between 2000 and 2012, 235 patients with advanced NSCLC (IIIB and IV) and Karnofsky Performance Status accounted 40-30, were qualified to PTR. In fact, 125 (53.2%) out of them were treated with PTR, and 110 (46.8%)-with SC alone, in accordance with patients expectations. There were no differences between PTR and SC group with respect to patient and tumor characteristics as well as with respect to the type and incidence of symptoms related to the local growth of NSCLC. In all 125 PTR patients the delivered tumor dose was 20Gy given in five daily fractions over five treatment days. All 110 patients who refused PTR were treated with SC in another hospital (28.2%), in a hospice (21.8%) or by general practitioners at home (50.0%).
  
  
  RESULTS
  The 90-day overall survival rate in the group of PTR patients was 20.0%, and in the group of SC patients it was 18.2%. Median survival amounted 58 and 59 days, respectively. The efficacy of PTR and SC, relative to the symptoms associated with the local growth of NSCLC, was comparable. Tolerance of PTR was poor and early toxicity-significant. Moreover 41.6% of irradiated patients received PTR within the last 30 days of their lives and 16.0% of these patients-within the last 15 days prior to death.
  
  
  CONCLUSIONS
  The life expectancy of patients with advanced NSCLC and poor performance status (Karnofsky 40-30), who presenting moderate or severe symptoms related to the local growth of cancer, is measured in days or weeks. The effective method of treatment for these patients is modern supportive care rather than PTR.
authors.affiliation: Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Walasek
authors.affiliation: Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland. Electronic address: z5korczy@cyf-kr.edu.pl.
authors.forename: Beata
authors.initials: B
authors.lastname: Sas-Korczyńska
authors.affiliation: Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dąbrowski
authors.affiliation: Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Reinfuss
authors.affiliation: Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jakubowicz
authors.affiliation: Palliative Care Unit, Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Blecharz
authors.affiliation: Department of Diagnostic Radiology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Łuczyńska
authors.affiliation: Palliative Care Unit, Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Darasz
authors.affiliation: Palliative Care Unit, Department of Radiation Oncology, Oncology Centre-Maria Skłodowska-Curie Memorial Institute Branch in Cracow, Poland, Garncarska 11, 31-115 Cracow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Skotnicki
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D016019:Survival Analysis; D019452:Terminally Ill; D013997:Time Factors; D016896:Treatment Outcome
keywords: Advanced lung cancer; Life expectancy; NSCLC; Palliative thoracic radiotherapy; Performance status; Supportive care