TITLE:
Palliative Treatment of Locally Advanced Non Metastatic Lung Cancer
AUTHORS:
Gael Kietga, Wilfried Mosse, Patricia Agbanglanon, Bertrand Compaore, Davy Nchepo, Evrard Seka, Sanae Elmajjaoui, Hanane Elkacemi, Tayeb Kebdani, Amine Lachgar, Noureddine Benjaafar
KEYWORDS:
Lung Cancer, Palliative Treatment, Locally Advanced
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.12 No.2,
February
9,
2021
ABSTRACT: Introduction: To determine the proportion and the reasons which
lead to palliative treatment in patients initially a candidate for concomitant
chemoradiotherapy (CCRT). Methods: A retrospective study including patients followed
for locally advanced lung cancer newly diagnosed from April 1, 2016, to
12/31/2017 in the radiotherapy department of the National Oncology Institute
who received palliative treatment. Results: We collected 52 patients out of a total of 225 stage
III patients (23%) followed by lung cancer candidates for CCRT who had
undergone palliative treatment. The mean age in our series was 61.23 years [22 - 81] with 86% male. The majority of patients (71%) had Performance
Status (PS) ≤ 2. Histological confirmation was obtained by pathological
examination in all our patients. It was an adenocarcinoma (ADK) in 54% of
cases; squamous cell carcinoma in 46% of cases. The reasons for palliative
treatment were mainly due to dosimetric constraints: large tumor volume 22/52
(42%); the tumor location close to the bone marrow in 15 of 52 (29%) patients;
and general Performance Status impairment (29%) in 15 of 52 patients.
Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients
(71%), among whom 19 (51%) were stable after 2 months of chemotherapy, in
palliative dose chest radiotherapy on the pulmonary parenchyma and/or mediastinum
in 10 of 52 (19%) patients, and supportive care in 5 (10 %) patients. We
observed 40/52 (77%) cases of stationary course, 04/52 (8%) cases of progress
to metastases, and 08/52 (15%) deaths before radiotherapy. Conclusion: A large proportion of patients followed for locally advanced
non-metastatic lung cancer are not eligible for curative treatment. The reasons
for the palliative treatment of patients followed for lung cancer candidates
for CCRT are variable but for a large proportion of patients due to the
deterioration of their state of health during their diagnostic journey. Hence, there is the need to improve the
early diagnosis and early management of
patients with lung cancer to avoid delayed care.