Emergency radiation therapy in modern-day practice: Now or never, or never again ?
Margaux YaouanqNyere GibsonAugustin BoudoussierLucas EdouardPierre PouvreauImed TalebWafa BouleftourPaul SargosNicolas MagnéNicolas Benziane-OuaritiniPublished in: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2024)
Radiation therapy plays a fundamental role in oncological emergencies such as superior vena cava syndrome (SVCS) and metastatic epidural spinal cord compression (MESCC). These are two examples of critical complications of metastatic cancer in terms of pain and functional impact (respiratory and/or neurological). The aim of this review is to explore the current indications, treatment options and outcomes for emergency radiotherapy regarding to these complications.Regarding SVCS, studies are mostly retrospective and unanimously demonstrated a beneficial effect of radiotherapy on symptom relief. Spinal cord compression remains an indication for urgent radiotherapy, and should be combined with surgery when possible. The innovative stereotactic body radiotherapy (SBRT) showed promising results, however this technique requires small volumes and more time preparation and therefore is often unsuitable for SVCS and MESCC emergencies.This review concluded that radiotherapy has a central role to play within a multimodal approach for SVCS and MESCC treatment. Further prospective studies are needed to confirm the effectiveness of radiation and establish the criteria for selecting patients to benefit from this treatment option.
Keyphrases
- radiation therapy
- locally advanced
- spinal cord
- radiation induced
- early stage
- squamous cell carcinoma
- vena cava
- rectal cancer
- neuropathic pain
- healthcare
- public health
- emergency department
- end stage renal disease
- small cell lung cancer
- spinal cord injury
- randomized controlled trial
- chronic kidney disease
- chronic pain
- ejection fraction
- newly diagnosed
- systematic review
- prostate cancer
- risk factors
- type diabetes
- coronary artery bypass
- young adults
- prognostic factors
- metabolic syndrome
- high resolution
- percutaneous coronary intervention
- brain injury
- combination therapy
- pulmonary embolism
- replacement therapy
- molecularly imprinted