A Single-Center Experience of the Same-Day Palliative Radiotherapy for Patients Referred to the Radiotherapy Department.

Abstract

Background: Rapid initiation of radiotherapy plays an increasingly important role in palliation of advanced cancer. Objective: We performed a retrospective analysis to determine the current status of same-day palliative radiotherapy in patients referred to the Radiotherapy Department of a medium-sized institution in Japan. Materials and Methods: The incidence by year, sex, age, primary cancer site, indication for radiotherapy, radiotherapy regimens, response rates to radiotherapy, and treatment waiting times were studied in 96 patients who received same-day palliative radiotherapy between 2016 and 2023. Results: The annual incidence of same-day palliative radiotherapy was 5.9%. The study included 61 males (aged 42-96) and 35 females (aged 42-97). The most common tumor was non-Hodgkin's lymphoma, followed by lung cancer. The main indications were malignant spinal cord compression and symptomatic brain metastases. Prostate cancer is the leading cause of malignant spinal cord compressions. Of the 96 patients, 84 received same-day palliative radiotherapy for oncological emergencies. Various radiotherapy regimens have been used, ranging from conventional 40 Gy in 20 fractions to hypofractionated 8 Gy in a single fraction. The response rates were 69.0% for spinal cord compression, 91.7% for symptomatic brain metastases, 100% for hollow organ compression and/or obstruction, and 100% for uncontrolled tumor bleeding. The mean time from the end of the consultation to the end of treatment was 262 ± 90 minutes. Conclusion: Same-day palliative radiotherapy is indispensable, especially in oncologic emergencies. Therefore, criteria for its appropriateness should be established.