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Vienna, Austria

ESTRO 2023

Session Item

Saturday
May 13
09:00 - 10:00
Business Suite 1-2
Palliative radiotherapy & SBRT
Nicolaus Andratschke, Switzerland
Poster Discussion
Clinical
Short course palliative radiotherapy in advanced solid tumors: a pooled analysis (SHARON PROJECT)
Costanza Maria Donati, Italy
PD-0065

Abstract

Short course palliative radiotherapy in advanced solid tumors: a pooled analysis (SHARON PROJECT)
Authors:

Costanza Maria Donati1, Gabriella Macchia2, Claudio Malizia3, Giambattista Siepe4, Alice Zamagni1, Francesco Cellini5, Milly Buwenge6, Savino Cilla7, Silvia Cammelli8, Stefania Rizzo9, Luciana Caravatta10, Tigeneh Wondemagegnhu11, A. F. M. Kamal Uddin12, Biniyam Tefera Deressa13, Mostafa A. Sumon11, Lidia Strigari14, Elisa Lodi Rizzini3, Alberto Bazzocchi15, Alessio Giuseppe Morganti8, Francesco Deodato2, Eleonora Farina16

1Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 2Radiotherapy Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, Campobasso, Italy; 3Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 4Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 5Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy; 6Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy; 7Medical Physics Unit, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy; 8Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 9Service of Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland; 10Radioterapia, Università degli Studi G. D’Annunzio, Chieti, Italy; 11Department of Radiation Oncology, Black Lion Hospital, Addis Ababa, Ethiopia; 12Department of Radiation Oncology, United Hospital Limited, Dhaka, Bangladesh; 13Department of Radiation Oncology, Black Lion Hospital , Addis Ababa, Ethiopia; 14Medical Physics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 15Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; 16Radiotherapy Unit, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy

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Purpose or Objective

Previous trials showed the tolerability and efficacy of a palliative radiotherapy (RT) regimen (SHARON) based on the 4 fractions delivered in 2 days in different oncological settings. In order to identify possible predictors of symptomatic response, the purpose of this study is to perform a pooled analysis of previous trials.

Material and Methods

We analyzed the impact on symptomatic response of the following parameters: tumor site, histological type, performance status (ECOG), dominant symptom, and RT dose using the chi-square test.

Results

One-hundred-eighty patients were analyzed. Median RT dose was 20 Gy (range: 14-20 Gy). The overall response rate was 88.8% (95%CI: 83.3%-92.7%) while pre- and post-treatment mean VAS was 5.3 and 2.5, respectively (p < .001). The overall response rate of pain, dyspnea, bleeding, dysphagia, and other symptoms was 86.2%, 90.9%, 100%, 87.5%, and 100%, respectively. Comparing the symptomatic effect based on the analyzed parameters no significant differences were recorded. However, patients with locally advanced disease showed a higher rate of symptomatic responses than metastatic ones (97.3% versus 83.0%; p = .021). Finally, the complete pain response rate was more than double in patients with mild to moderate (VAS: 4-7) compared to those with severe (VAS > 7) pain (36.0% versus 14.3%; p = .028).


Conclusion

This pooled analysis showed high efficacy of the SHARON regimen in the relief of several cancer-related symptoms. The markedly and significantly higher complete pain response rate, in patients with mild-moderate pain, suggests an earlier referral to palliative RT for patients with cancer-related pain.