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Paper Details

Palliative Radiotherapy Between Scientific Evidence and Technological Evolution: Role of Clinic Appropriateness an the Choice of Treatment

Sara Falivene, Rossella Di Franco, Francesca Maria Giugliano, Valentina Borzillo, Angela Argenone, Vincenzo Ravo, Paolo Muto


Purpose: purpose is to assess the impact of radiatiotherapy with palliative purposes in the department of Radiation Oncology , use of advanced technologies in palliation and impact on management of patients were to be enrolled in medical treatments Methods and Materials: We have evaluated the treatments made in 2013 in our department. At the Institute can effect treatments in 3DCRT, brachytherapy, and from November 2012 Cyberknife system is available for SRT and SRS treatments. We have considered impact of treatments with palliative purposes for each type of technique used. Risultati: In 2013, 874 patients were treated: for brain metastases, 149 in total, were performed with 3DCRT technique (Whole Brain) in 22 patients, with special technique in 127 patients including (77% radiosurgery ; 23% fractionated stereotactic radiotherapy. SRT have a dominant role in presence of a number of secondary encephalic lesions less than or equal to 4 because SRT is a selective treatment that preserves whole brain, and structures as the brainstem, chiasm, optic nerves, and then fits the cognitive functions and relationships. 110 treatments were done for bone metastases with 3DCRT (68 treated with 8 Gy, 76 with 30 Gy, 44 with 20 Gy, 2 with 40 Gy); in 2012 started the experience with the Cyberknife system and were treated 199 patients with 3DCRT, 1 patient with the Cyberknife system for retreatment of spinal metastasis. In 2013, 203 palliative treatments for bone metastases were performed, with 3DCRT technique in 185 patients,18 with special technique. Conclusion: Our experience shows that palliation is a common indication in radiotherapy, but careful patient selection is essential for the choice of radiotherapy technique and dose fractionation. We should not consider the palliative treatment of secondary importance, so even in the palliation need to promote research and technology to optimize results.