Deterioration of Performance Status during Palliative Radiotherapy Suggests a Significant Short Survival Duration: Indicating the Necessities for Considering Radiotherapy Discontinuation

Discontinuation of palliative radiotherapy due to a patient's declining general condition poses a clinical dilemma for palliative care physicians. This study aimed to investigate the survival duration of patients whose performance status (PS) deteriorated during palliative radiotherapy and info...

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Bibliographic Details
Published in:Current oncology (Toronto) 2024-04, Vol.31 (4), p.1752-1761
Main Authors: Maemoto, Hitoshi, Kushi, Kazuaki, Owan, Isoko, Ariga, Takuro, Heianna, Joichi, Nishie, Akihiro
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
cancer
Female
Humans
Male
Medical research
Medicine, Experimental
Middle Aged
Neoplasms - mortality
Neoplasms - radiotherapy
palliative care
Palliative Care - methods
Palliative treatment
performance status
Radiotherapy
Retrospective Studies
Withholding Treatment
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Summary:Discontinuation of palliative radiotherapy due to a patient's declining general condition poses a clinical dilemma for palliative care physicians. This study aimed to investigate the survival duration of patients whose performance status (PS) deteriorated during palliative radiotherapy and inform decisions regarding early treatment discontinuation. We retrospectively analyzed data from patients referred from our institute's palliative care department who underwent ≥10 fractions of palliative radiotherapy between March 2017 and December 2021. PS was assessed using the Eastern Cooperative Oncology Group (ECOG) scale. Survival duration was calculated from the final day of palliative radiotherapy to death using the Kaplan-Meier method. A total of 35 patients underwent palliative radiotherapy. Seven (20%) experienced deterioration in ECOG PS during treatment. Their median survival duration was significantly shorter at 22 days (95% confidence interval: 1-94 days) compared to 125 days (95% confidence interval: 82-150 days) for the 28 patients whose PS remained stable ( = 0.0007). Deterioration in ECOG PS during palliative radiotherapy signifies a markedly shorter survival duration. Careful assessment of a patient's condition throughout treatment is crucial, and early discontinuation should be considered if their general health worsens rather than strictly adhering to the initial schedule.
ISSN:1718-7729
1198-0052
1718-7729
DOI:10.3390/curroncol31040133