A Medical Research Council (MRC) randomised trial of palliative radiotherapy with two fractions or a single fraction in patients with inoperable non-small-cell lung cancer (NSCLC) and poor performance status
1992

Palliative Radiotherapy for Non-Small-Cell Lung Cancer

Sample size: 233 publication Evidence: moderate

Author Information

Author(s): N.M. Bleehen, D.J. Girling, D. Machin, R.J. Stephens

Primary Institution: Medical Research Council

Hypothesis

Can a single fraction of radiotherapy provide equally good palliation as a two-fraction regimen in patients with inoperable non-small-cell lung cancer?

Conclusion

The single-fraction regimen is recommended as it causes little dysphagia and requires only one treatment session.

Supporting Evidence

  • 95% of patients had cough, 47% had haemoptysis, 59% had chest pain, 64% had anorexia, and 16% had dysphagia.
  • The median survival was 100 days in the two-fraction group and 122 days in the single-fraction group.
  • Palliation was achieved in high proportions of patients, with similar results in both treatment groups.
  • Dysphagia occurred in 56% of patients in the two-fraction group compared to 23% in the single-fraction group.

Takeaway

Doctors wanted to see if giving one big dose of radiation instead of two smaller doses would help patients with lung cancer feel better. They found that one dose worked just as well and was easier for patients.

Methodology

Patients were randomly assigned to receive either two fractions of 8.5 Gy or a single fraction of 10 Gy of radiotherapy.

Limitations

The study was limited to patients with poor performance status, which may not represent all patients with NSCLC.

Participant Demographics

79% male, 73% aged 65 or over, 70% had squamous cell tumors.

Statistical Information

Confidence Interval

95% CI 17-48%

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