Jamora Kurl E, Cupino Nonette A
Division of Radiation Oncology, Department of Radiology, Philippine General Hospital, University of the Philippines Manila.
Acta Med Philipp. 2023 Aug 29;57(8):38-45. doi: 10.47895/amp.vi0.4147. eCollection 2023.
This study aimed to describe the clinical profile and treatment outcomes of patients treated with a short course (<10 fractions) of palliative radiotherapy during the first year of the COVID-19 pandemic. Another aim of the study is to compare patients treated with short-course and long-course palliative radiotherapy in terms of the site and volume irradiated.
An ambispective study comprised 23 patients treated with short-course palliative radiotherapy from March 2020 to February 2021. The retrospective aspect of this study included a review of medical records and radiotherapy plans, while the prospective part involved communication with patients or legally authorized representatives via phone call. Demographic, clinical, and treatment-related information were gathered.
Of 92 patients receiving palliative radiotherapy, 23 were treated with a short course, while 69 were planned for at least ten fractions. Of the 23 patients receiving short-course radiotherapy, most had colorectal (35%) and head and neck (26%) primary malignancies. The most commonly treated sites were the pelvis (24%), vertebral bones (21%), and head and neck masses (21%), and the most common indications were pain (45%) and bleeding (32%). The majority were treated with 20 Gy in 5 fractions (42%) and 25 Gy in 5 fractions (38%). Complete resolution of symptoms was observed in 43% of cases, and more than half reported no side effects (58%). Median survival was 71 days. All patients treated in the lung, stomach, and brain underwent a long course of palliative radiotherapy. Patients with a long course also had higher mean irradiated volumes (1871 cm vs. 2150 cm).
In this single institution review, a short course of palliative radiotherapy was proven to provide good symptom control with few side effects. During the COVID-19 pandemic, its use should be strongly considered, especially in patients with poor performance status, transportation difficulties, and limited life expectancy.
本研究旨在描述在2019年冠状病毒病（COVID-19）大流行的第一年接受短疗程（<10次分割）姑息性放疗患者的临床特征和治疗结果。本研究的另一个目的是比较接受短疗程和长疗程姑息性放疗患者的照射部位和体积。
一项前瞻性和回顾性相结合的研究纳入了2020年3月至2021年2月接受短疗程姑息性放疗的23例患者。本研究的回顾性部分包括对病历和放疗计划的审查，而前瞻性部分则涉及通过电话与患者或法定授权代表进行沟通。收集了人口统计学、临床和治疗相关信息。
在92例接受姑息性放疗的患者中，23例接受了短疗程治疗，而69例计划至少进行10次分割。在23例接受短疗程放疗的患者中，大多数患有结直肠癌（35%）和头颈部（26%）原发性恶性肿瘤。最常治疗的部位是骨盆（24%）、椎骨（21%）和头颈部肿块（21%），最常见的适应证是疼痛（45%）和出血（32%）。大多数患者接受了5次分割的20 Gy（42%）和5次分割的25 Gy（38%）治疗。43%的病例症状完全缓解，超过一半的患者报告无副作用（58%）。中位生存期为71天。所有在肺部、胃部和脑部接受治疗的患者均接受了长疗程姑息性放疗。长疗程患者的平均照射体积也更高（1871 cm³对2150 cm³）。
在本单机构回顾中，短疗程姑息性放疗被证明能有效控制症状且副作用较少。在COVID-19大流行期间，应强烈考虑使用，尤其是对于身体状况较差、交通不便和预期寿命有限的患者。
