Comparative Study Between 17 Gy in 2 Fractions and 36 Gy in 12 Fractions Radiotherapy to Primary Site for Palliation of Symptoms in Stage IV Non-Small Cell Lung Cancer

Background: Half of NSCLC patients present with stage IV disease where a cure is not possible. The use of a hypofractionated RT schedule has economic and logistic advantages for Radiation Oncology departments and a higher degree of patient convenience than conventional fractionation. Objective: To evaluate outcomes between 17 Gy in 2 fractions and 36 Gy in 12 fractions RT regarding relief of thoracic symptoms in IV NSCLC patients. Methods: This quasi-experimental study was done at the Radiation Oncology Department, NICRH from July, 2022 to June, 2023. A total of sixty (60) study participants were assigned into two groups, 30 in each arm. Arm-A received 17 Gy in 2 fractions, 1 week apart and Arm-B received 36 Gy RT in 12 fractions in two and half weeks. Result: About 68.33% of participants were between 40 to 60 years. In Arm-A, among 30 participants there were 22 (73.3%) male and 8 (26.7%) female. In Arm-A, 26 (86.7%) participants were in stage IVA and 4 (13.3%) were in stage IVB, and in Arm-B 28 (93.3%) participants were in stage IVA and 2 (6.7%) were in stage IVB. The response was evaluated in both arms. In Arm-A, 10 (33.3%) participants showed partial response (PR) and 11 (36.7%) participants showed partial response (PR) in Arm-B. According to ECOG-PS, In Arm-A, among 2 participants with PS ECOG -0, 1 participant developed a partial response and the other one had a stable disease. Conclusion: Hypofractionated RT with 17 Gy in 2 fractions renders similar symptom relief with minimum toxicities compared with 36 Gy in 12 fractions RT to a primary lesion in stage IV NSCLC.