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A considerable proportion of patients with end-stage or terminal cancer do not benefit from palliative radiation therapy ( radiotherapy ), a new analysis found.

A new analysis has found that a considerable proportion of patients with end-stage or terminal cancer do not benefit from palliative radiation therapy ( radiotherapy ) despite spending most of their remaining life undergoing treatments. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the study indicates that greater efforts are needed to tailor appropriately palliative radiotherapy to patients with end-stage cancer.

Palliative radiotherapy for end-stage cancer patients is intended to control cancer-related pain and other symptoms and to help patients maintain a good quality of life when long-term cancer control is not possible. By reducing the number of cancer cells, palliative radiotherapy can ease pain, stop bleeding, and relieve pressure, even when the cancer cannot be controlled. However, for many patients, the treatments are not effective.

To investigate the adequacy 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 were referred for palliative radiotherapy at their hospital from December 2003 to July 2004 and who died within 30 days. The investigators identified 33 such patients.

Radiotherapy was delivered to 91 percent of patients. Half of the patients spent more than 60 percent of their remaining lifespan on radiotherapy, and in only 58 percent of patients was radiotherapy completed. Many physicians overestimated the length of time their patients would survive. Among this group who died within one month, about one in five physicians predicted more than six months survival. In addition, progressive complaints were noted in 52 percent of patients, and palliation or pain reduction was reported by only 26 percent of patients.

To be 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. Excessive radiotherapy in end-stage cancer patients may reflect overoptimistic prognoses and unrealistic concerns about radiation damage.

Source: ACS

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