TAILIEUCHUNG - Palliative cancer care and radiation oncology: Part 2

(BQ) Continued part 1, part 2 of the document Palliative cancer care and radiation oncology has contents: Palliative radiotherapy for gastrointestinal and colorectal cancer, genitourinary malignancies, hematologic malignancies and associated conditions, pediatric palliative radiation oncology,. and other contents. Invite you to refer. | CHAPTER 15 Palliative radiotherapy for gastrointestinal and colorectal cancer Robert Glynne-Jones Mark Harrison Mount Vernon Centre for Cancer Treatment Mount Vernon Hospital Northwood London UK Introduction The aims of palliative radiation therapy RT are to alleviate symptoms restore function diminish suffering and improve quality of life. Palliative RT has been shown to be an effective and simple method of providing relatively rapid relief in both locally advanced and metastatic cancer 1 2 for symptoms of pain bleeding ulceration compression or obstruction. It is accepted that the majority of patients will have a limited life span and the duration of symptom relief may be short. Box lists the indications for use of palliative radiotherapy. More than 50 years of experience means that safe doses of radiation can be delivered quickly in one or a few daily fractions. Although larger fraction sizes may lead to increased late effects this toxicity will take months or years to develop and is unlikely to prove problematic in a population with a short life span. Current palliative radiotherapy regimens for colorectal and gastrointestinal cancer commonly deliver doses ranging from 8 Gy as a single fraction 20-25 Gy in 5 fractions 30 Gy in 10 fractions to 27-30 Gy in 6 fractions over 3 weeks Figure . We often have insufficient information to choose the optimal regimen. Very few studies have used validated endpoints for symptom relief or have included formal measures of quality of life. Hence it is probably best to tailor radiation fraction regimens and duration of treatment to the individual and their estimated survival time although due to their close patient contact oncologists tend to be overly optimistic and unrealistic. This chapter reviews the role of palliative radiation therapy in gastrointestinal and colorectal cancer as well as the selection of patients who are appropriate for radiotherapy. Patients with advanced gastrointestinal and colorectal Radiation

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