Topkan, E., Yildirim, B.A., Guler, O.C., Parlak, C., Pehlivan, B., & Selek, U. (2015). Safety and palliative efficacy of single-dose 8-Gy reirradiation for painful local failure in patients with stage IV non-small cell lung cancer previously treated with radical chemoradiation therapy. International Journal of Radiation Oncology, Biology, Physics, 91, 774–780.
To investigate the safety and efficacy of single-dose palliative chest reirradiation for pain control
Patients who had been treated with three-dimensional conformal radiation therapy (RT) and concurrent cisplatin-based therapy were given reirradiation to the chest area previously included in the > 90% prescribed dose region. Pain management was evaluated according to the World Health Organization step ladder.
Retrospective, descriptive study
There were no radiation-associated toxicities greater than grade 2. The median VAS score before reirradiation was 7 (range = 4–9), and the median score after reirradiation was 3 (range = 0–8, p < 0.001). Thoracic disease was stabilized in 33.3% of patients and partially regressed in 21.1%. No factors predicting better pain responses were identified.
Reirradiation to the chest area was effective for most patients in reducing pain associated with non-small cell lung cancer. It was not associated with severe adverse effects. Two patients developed esophagitis, and three developed pneumonitis. The median time to the lowest pain score was 27 days, and the mean duration of relief was 6.1 months.
Locoregional failures at the margins of previous RT fields can be associated with severe pain in patients with lung cancer. This study suggested that single-dose reirradiation may reduce pain.