Radiation therapy is frequently delivered with palliative intent. It can reduce pain, neurological dysfunction, bleeding, fungating wounds, nausea, vomiting, or obstructive symptoms. Painful bone metastases are the most common reason for palliative radiation therapy, and radiation therapy has proven response rates of 70–80% in multiple clinical trials. Treatment of brain metastases can help control neurological symptoms. Palliative radiation can also be used to treat head and neck cancer, liver or pelvic tumors, superior vena cava syndrome, or skin cancer. Since palliative radiation is typically delivered at low doses, re-irradiation may be provided without much risk of additional toxicity.
Palliative radiotherapy offers a quick, inexpensive, and effective way of reducing many of the focal symptoms of advanced, incurable cancer, whether these arise from the primary tumour or from metastatic deposits. It can improve quality of life while being associated with limited treatment burden in terms of both hospital attendances and side effects.1 The average UK general practice oversees care for around 20 patients with terminal cancer each year with higher numbers seen in secondary care,23 while a Canadian survey of general practitioners found that 85% had provided care for patients with advanced cancer within the previous month.4 This article aims to update non-specialists on the benefits, practicalities, and side effects of palliative radiotherapy to ensure that patients are considered and referred for these treatments when appropriate.
Palliative radiation treatments can be especially helpful for cancer patients who have:
A cancer that has spread (metastasized) to the bones or brain.
A tumor that is pressing on the spinal cord and could affect the ability to walk or move.
A tumor that is making it hard to eat, breathe or have bowel movements.
Bleeding in the stomach, throat, bladder or other parts of the body.
Palliative Radiation Treatments
Many patients receive palliative radiation therapy 5 days a week for 1 to 3 weeks. However, some patients have fewer treatments or only 1 treatment. The procedures take a few minutes each and are not painful.