Palliative Treatment of Locally Advanced Non Metastatic Lung Cancer
- 1 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 2 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 3 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 4 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 5 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 6 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 7 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 8 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 9 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 10 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
- 11 Radiotherapy Department, National Institute of Oncology, Rabat, Morocco
Abstract
Introduction : To determine the proportion and the reasons which lead to palliative treatment in patients initially a candidate for concomitant chemoradiotherapy (CCRT). Methods : A retrospective study including patients followed for locally advanced lung cancer newly diagnosed from April 1, 2016, to 12/31/2017 in the radiotherapy department of the National Oncology Institute who received palliative treatment. Results : We collected 52 patients out of a total of 225 stage III patients (23%) followed by lung cancer candidates for CCRT who had undergone palliative treatment. The mean age in our series was 61.23 years [22 - 81] with 86% male . The majority of patients (71%) had Performance Status (PS) ≤ 2. Histological confirmation was obtained by pathological examination in all our patients. It was an adenocarcinoma (ADK) in 54% of cases; squamous cell carcinoma in 46% of cases. The reasons for palliative treatment were mainly due to dosimetric constraints: large tumor volume 22/52 (42%); the tumor location close to the bone marrow in 15 of 52 (29%) patients; and general Performance Status impairment (29%) in 15 of 52 patients. Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients (71%) , among whom 19 (51%) were stable after 2 months of chemotherapy, in palliative dose chest radiotherapy on the pulmonary parenchyma and/or mediastinum in 10 of 52 (19%) patients, and supportive care in 5 (10 %) patients. We observed 40/52 (77%) cases of stationary course, 04/52 (8%) cases of progress to metastases, and 08/52 (15%) deaths before radiotherapy. Conclusion : A large proportion of patients followed for locally advanced non-metastatic lung cancer are not eligible for curative treatment. The reasons for the palliative treatment of patients followed for lung cancer candidates for CCRT are variable but for a large proportion of patients due to the deterioration of their state of health during their diagnostic journey. Hence , there is the need to improve the early diag nosis and early management of patients with lung cancer to avoid delayed care.
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