The value of radiotherapy in controlling specific cancer-related symptoms is undisputed and can be achieved with unsophisticated and undemanding schedules. Yet, more research is needed to answer the critical issues of the role of radiotherapy in the treatment of non-small cell lung cancer As far as quality of life studies are concerned, there are several studies to help answer some of these issues. Kaasa et al randomised 95 patients to receive either radiotherapy or chemotherapy. They found significant differences in psychosocial well-being and global quality of life in favor of radiotherapy. There were no significant group differences in physical functioning and daily activities. A British study has shown that conventional and experimental radiotherapy policies are the same both in survival time and quality of life. The study suggested that dysphagia and reduction in physical activities were the most important side effects of the radiotherapy. Considering these side effects that affect a patient’s quality of life, consequent studies indicated that there were no survival benefits with multiple or even two fractions as compared with single-fraction radiotherapy. The quality of life assessment as measured by the DDC, the HADS, and the RSCL showed that disease-related symptoms improved, anxiety improved, depression was unchanged, and there was less dysphagia in favor of single fraction. In their recent study comparing short vs aggressive radiotherapy, they found that survival improved slightly in favor of the aggressive regimen, but in other respects (palliation of main symptoms, adverse effects, response, appearance of metastases), the two regimens were very similar. antibiotics online
Adjuvant Chemotherapy With Radiotherapy
A recent meta-analysis of randomized trials of combined chemotherapy and radiotherapy in nonsmall cell lung cancer concluded that cisplatin-based chemotherapy and radiotherapy are superior to the other regimens, but these results must be considered in the light of the balance among quality of life, toxicity, and costs of chemotherapy. There are a few studies that examine the quality of life. Early studies used the KPS as the proxy of quality of life and had shown different results. Arcangeli et al reported that chemotherapy plus radiotherapy improved a patient’s performance status markedly, while Minet et al, in a randomized trial comparing radiotherapy alone vs radiotherapy along with chemotherapy found that there was no significant difference between treatment arms in both survival and quality of life. In a study in which patients were randomized to receive radiotherapy alone, radiotherapy plus chemotherapy, or palliative treatment, the results suggested that the patients who received radiotherapy or radiotherapy plus chemotherapy had fewer physical and psychological problems as compared with those who received palliative treatment.