321

RADICTlHERAPEUTIC PALLIATIGN OF SPIRAL EPIWRAL OOMPRESSION IN

SMALL CELL m CANCER FL @iI, HW Chin, FS Bahrassa, Louisiana State University School of Medicine, Shreveport, Louisiana, U.S.A.

There is relatively little informat ion about the results of managewent by radiotherapy (RTI of spinal epidura I conpress i on(SEC) in smal I-ccl I lung cancer(SClC). Sixteen patients with SEC by metastatic SCLC were treated for palliation by RT between 1980 and 1990. Lower I it& motor deficit was the most prominent clinical manifestation. Neurologic dysfunction was comeonly present for more than 48 hours. Median interval between lung and epidural ttsaor diagnosis was 8.5 months. Overa I I one-year survival rate was 12%. Significant pain relief occurred in 89% of synptomat ic individuals(n=9). One-third of initially non-ambulatory evaluable(n=9) subjects were able to walk again. Anal/bladder sphincter or sensory disturbance did not inprove in four persons. Radiotherapy for SEC in SCLC. albeit not curative, is highly effective in relieving pain and may inprove limb motion dysfunction in some patients.

323

89

322

PROSPBCIWB RANDOMISED TRIAL OF PALLL4TIVB BADIOTRBRAlV (ItT) GIVEN IN ‘IWO FRACTIONS (F2) OR ONRFRACITON (Fl) FORPATIRNTS WlTli INOPERABLE

NON-SMMd.-CRLL LUNG CANCER (NSCLC) AND POOR PERFORMANCE STATUS

Bdtlsh Medical Bewarcb Coundl Lang Csncer Work& pnrty; p~sented by N M Bledwe, MRC Climical Ckuola(ly aad Rmdlotbwapu~tlcr Unit, Hills Road, CawbriaBe, CB2 ZQR, UR

233 patients with inoperable NSCLC and performance status of WHO grade 2-4 were admitted from 10 centres to a trial aimed at simplifying palliative RT. Au had their main symptoms related to intrathoracic hunour even if metastases were present, and had disease too advanced for radical RT. They were allocated at random to receive thoracic RT with either 17 Gy in 2 fractions of 8.5 Gy 1 week apart (116 patients), a regimen shown to be effective in a previous MRC study (Br J Cancer 1991; 63:265-m)), or 10 Gy in a single fraction (117 patients). As assessed by the clinicians, the two regimens had simii palliative effect. Cough was palliated in 48% of 112 F2 and 56% of 108 Fl patients with cough on admission, haemoptysis in 75% of 55 and 72% of 54, and chest pain in 59% of 66 and 72% of 71, respectively. The median percentage of survival time during which there was palliation was 50% in the F2 and 50% in the Fl group for cough, 74% and 72% for haemopqsis, and 50% and 50% for chest pain, respectively. As recorded daily by the patients using a diary card, the F2 regimen caused substantiaJly more dysphagia, which was recxxded in 57% of patients compared with 23% in the Fl group (difference 34% 95% CI 1848%). Although the median survival time from ah&ion was 16 weeks in the F2 group and 18 weeks in the Fl group there was no sigaiticaat difference in overall survival. In comhsion, the single fraction (Fl) regimen is recommended as a palliative regimen for patients with inoperable NSCLC and poor performance status.

324

Radiation Oncology Center, Mallinckrodt Znstitute of Radiology, Washington University School of Medicine St. Louis Missouri USA