New Pelvic Tumor Radiation Regimen Safe, Effective for Palliation

The study was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Palliative radiation at 25 Gy delivered in five fractions is safe and effective for symptomatic pelvic tumors.

Why This Matters

  • Palliative radiotherapy is a standard option for bleeding or painful pelvic tumors.

  • The conventional dosage is 20 Gy in five fractions or 30 Gy in 10 fractions.

  • A dose of 25 Gy in five fractions splits the difference, offering the advantage of a higher biologically effective dose over a shorter time interval.

  • The study is the first to report the efficacy and safety of the approach across a broad range of pelvic tumors.

Study Design

  • Investigators reviewed outcomes for 34 patients, which included 14 with gynecological cancer, five with rectal cancer, seven with metastatic pelvic bone tumors, five with metastatic pelvic lymph node tumors, and one each with synovial sarcoma of the pelvis, prostate cancer, and urothelial cancer.

  • Overall, 16 patients had bleeding, 17 had pain, and one had both.

  • Hemostasis was evaluated by pre- and post-treatment hemoglobin levels; pain was assessed by a numerical rating scale.

  • Radiation was delivered by a linear accelerator with a 3-dimentional conformal technique.

  • To reduce exposure to healthy gastrointestinal tissue, beams were delivered from multiple directions.

Key Results

  • At a median follow-up of 4 months, 14 of 17 patients (82%) had a hemostatic response, and hemoglobin decline slowed in the remaining three.

  • In addition, 14 of 18 patients (78%) had pain relief.

  • Among the four patients who did not have pain relief, three had sarcoma and one had renal cell cancer.  

  • Acute adverse effects were all grade 1 and included diarrhea in three patients plus dermatitis and urinary frequency in one patient each.

  • No late adverse events were observed.

 Limitations

  • It was a small, retrospective study with short follow-up.

  • Toxicity and treatment responses were not evaluated on a fixed schedule.

Disclosures

  • There was no study funding, and the investigators didn’t have any competing interests.

This is a summary of a preprint research study, “Safety and efficacy of 25 Gy in 5 fractions of palliative radiotherapy for symptomatic pelvic tumors,” led by Tomomi Aoshika of the Saitama Medical University, Japan. The study has not been peer reviewed. The full text can be found at researchsquare.com.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected]

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