Pancreatic cancer Indications for palliative radiotherapy A diagnosis of pancreatic cancer is devastating; the 5-year overall survival for patients with locally-advanced unresectable disease is less than 5%, and for patients with metastatic disease is worse. At least 50% of patients…
Introduction The definition of palliative care by the World Health Organization (WHO) is centered around “an approach that improves the quality of life of patients … through the prevention and relief of suffering ….” One of the most important and…
Introduction Patients with advanced lung cancer may experience a variety of symptoms that can cause suffering, including (but not limited to) anxiety, dyspnea, fatigue, nausea, and pain. Palliative radiation to the thorax can ameliorate these symptoms in an attempt to…
Introduction Head and neck cancers represent the sixth most common cancer worldwide, with approximately 630,000 new patients diagnosed annually. While many advances within the field of head and neck cancer have focused on the improvement of curative-intent treatment, there remains…
Principles of reirradiation The guiding principle of “Do No Harm” lies at the heart of reirradiation, as the limits of radiation therapy are bounded by the potential for morbidity. Patients are commonly referred for reirradiation in two distinct clinical settings.…
Introduction Historically, systemic therapy played the primary role in the management of metastatic disease, while radiation therapy (RT) was primarily reserved for palliation of symptoms and sequelae of metastatic disease including pain, bleeding, compression, risk of fracture, and neurological compromise.…
Introduction More than 16.9 million people are living with cancer in the United States, and approximately 1.8 million new cancer cases are expected to be diagnosed in 2020. The population of cancer survivors in the United States is predicted to…
Introduction It is estimated that up to 40% of patients with advanced cancers will receive palliative radiation therapy (RT) during the course of their disease. While specific details of patient, treatment modality, and dose selection are discussed elsewhere in this…
General considerations The choice of appropriate treatment modality in the curative setting is typically based on efficacy for cure and avoidance of severe adverse effects. Historical experience, theoretical considerations of radiobiology, and results of research studies (especially randomized controlled trials)…
What is the approach to the patient referred for palliative radiotherapy? While most patients with advanced or metastatic cancer referred for consideration of palliative radiotherapy will undergo radiation treatment, deciding who is a candidate for palliative radiotherapy and if so,…