A prospective trial of short-fractionation radiotherapy for the palliation of liver metastases
S Bydder
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorNA Spry
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorDRH Christie
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorD Roos
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorBH Burmeister
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorH Krawitz
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorS Davis
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorDJ Joseph
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorM Poulsen
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorM Berry
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorS Bydder
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorNA Spry
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorDRH Christie
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorD Roos
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorBH Burmeister
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorH Krawitz
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorS Davis
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorDJ Joseph
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorM Poulsen
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorM Berry
1 Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, 2 East Coast Cancer Centre, John Flynn Hospital, Gold Coast, 3 Oncology Services, Princess Alexandra Hospital, Brisbane and 4 Queensland Radium Institute Centre, South Brisbane, Queensland, 5 Royal Adelaide Hospital, Adelaide, South Australia, 6 William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, 7 Liverpool Hospital, Sydney, New South Wales, Australia and 8 Auckland Public Hospital, Auckland, New Zealand
Search for more papers by this authorS Bydder FRANZCR; NA Spry FRANZCR; DRH Christie FRANZCR; D Roos FRANZCR; BH Burmeister FRANZCR; H Krawitz FRANZCR; S Davis FRANZCR; DJ Joseph FRANZCR; M Poulsen FRANZCR; M Berry FRANZCR.
Summary
The purpose of this study was to prospectively examine the effectiveness and tolerability of a simple radiotherapy technique for the palliation of symptomatic liver metastases. Twenty-eight patients with symptomatic liver metastases were enrolled from seven centres, and received targeted (partial or whole) liver irradiation consisting of 10 Gy in two fractions over 2 days. Symptoms at baseline were hepatic pain (27 patients), abdominal distension (19), night sweats (12), nausea (18) and vomiting (eight). Twenty-two patients (76%) had failed previous treatment with chemotherapy, hormonal therapy and/or high-dose steroids. Symptoms and potential toxicities were prospectively assessed at the time of treatment, then 2, 6 and 10 weeks later. Individual symptom response rates were 53−66% at 2 weeks. Partial or complete global symptomatic responses were noted in 15 patients (54%) overall. The treatment was well tolerated with two patients (7%) experiencing grade 3 toxicity (one vomiting and one diarrhoea); however, four patients reported temporary worsening of pain shortly after treatment. This simple and well-tolerated treatment achieves useful palliation.
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