title: Analysis of patterns of palliative radiotherapy in north west India: a regional cancer center experience.
abstract: BACKGROUND
  Palliative radiotherapy (PRT) is the eventual requirement in 30-50% of all cancer patients. PRT is primarily aimed to relieve pain and prevent/treat collapse or fracture in case of bone metastasis, to reduce edema in patients with cranial metastasis, and to control distressing symptoms of rapid primary growth. An audit of PRT planned in a busy cancer center can help in the characterization of the requirements of the patients and the formulation of institutional policies.
  
  
  METHODS
  In total, 516 patients who received PRT in our regional cancer center from January 2012 to December 2012 and whose complete records were available for analysis were selected for this retrospective study. Medical records and radiotherapy files were analyzed to obtain data such as sociodemographic parameters, prescription of PRT, and follow up. Descriptive statistics were evaluated in terms of frequencies and percentages to allow comparisons.
  
  
  RESULTS
  Of the 516 patients, 73% patients were male; the median age of the patients receiving PRT was 62 years (range 13-83 years). About 48% (n = 248) patients received PRT at the primary site while rest (52%) were given PRT at the metastatic site. The most common indication of PRT was pain (56.8% cases), followed by cytostatic PRT (19.8%) and raised ICT (12.4%). The median dose prescribed was 30 Gy (range 8-36 Gy) delivered in 1-12 fractions over the duration of 1-18 days. The overall response rate was about 43% at 2 weeks of completion of PRT; the median follow-up of the patients was 154 days (range 9-256 days). The long-term symptom relief at median follow up was 8%.
  
  
  CONCLUSIONS
  Good clinical judgment and expertise is required in prescribing correct fractionation schedule to achieve effective symptom palliation with lowest possible cost and inconvenience to the patients and relatives. Hypofractionated radiotherapy is a feasible treatment option in patients with advanced incurable disease to achieve effective palliation.
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Akhil
authors.initials: A
authors.lastname: Kapoor
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Mukesh Kumar
authors.initials: MK
authors.lastname: Singhal
authors.affiliation: Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Narender
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kalwar
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Puneet Kumar
authors.initials: PK
authors.lastname: Bagri
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Satya
authors.initials: S
authors.lastname: Narayan
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Raj Kumar
authors.initials: RK
authors.lastname: Nirban
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner, Rajasthan, India.
authors.forename: Harvindra Singh
authors.initials: HS
authors.lastname: Kumar
keywords: North West India; Palliative radiotherapy; Regional cancer center; Sociodemographic parameters