Controlled trial of palliative radiotherapy given in two fractions or conventionally fractionated for inoperable non-small-cell lung cancer

A total of 374 patients with inoperable non-small cell lung cancer were admitted to the study from March 1985 to February 1988. AU had their main symptoms related to tumour in the chest, even if metastases were present, and had disease too advanced for
radical radiotherapy. They were randomised on admission to receive either high-dose (HD) radiotherapy (17 Gy in two fractions of 8 5 Gy one week apart) or conventional dose
(CD) radiotherapy (30 Gy in 10 fractions in two weeks, or 27 Gy in six fractions in two weeks). The nature and severity of symptoms were recorded monthly by the clinicians.
Nausea, vomiting, dysphagia, level ofphysical activity, mood and overall condition were recorded daily by patients using a diary card. The two regimens achieved similar palliation of symptoms, and both caused a temporary and similar increase in dysphagia. There was no difference between the two series in survival from admission (p = 0-16, log rank test), the median survival periods being HD 28 weeks and CD 31 weeks. The two fraction regimen (HD) is therefore recommended.