Palliative Hypofractionated Radiotherapy in South Egyptian Patients with Stage III and IV Non-Small Cell Lung Cancer

More than two third of patients with non-small cell lung cancer (NSCLC) presented with advanced stage (III and IV) [1]. The majority of patients with unresectable stage III NSCLC are unfit for radical chemoradiotherapy (CRT) either due to the presence of extensive intrathoracic disease, poor performance status or significant comorbidities. Many patients with metastatic lung cancer and locally advanced disease presented with thoracic symptoms such as, cough, dyspnea, chest pain and hemoptysis necessitating thoracic radiotherapy. Thoracic radiotherapy is effective in palliating these symptoms in about 90% of patients with advanced NSCLC [2-4]. There have been 14 published randomized clinical trials evaluating the optimal hypofractionation regimen to palliate symptoms of advanced NSCLC, which are considerably less resource and time intensive [1,2,5-16]. However there is still no consensus on which fractionation scheme should be used. If one assumes an α /β of 2 for late responding tissues, 17 Gy in 2 fractions is the radiobiologic equivalent of 45 Gy in 25 fractions or 36 Gy in 12 fractions by the linear-quadratic formula [17]. Its use in the palliative setting for patients with advanced NSCLC has compared favorably with other regimens in terms of palliation (810). Owing to the crowdedness and overloading at our institute, in addition to lack of an effective referral system to our center with limited facilities and services provided for the patients care, 17 Gy in 2 fractions, seems logistic , as it alleviate the crowdedness Volume 3 Issue 6 2015