Palliative radiotherapy is effective for both well‐ and poorly differentiated neuroendocrine neoplasms

Author:

O'Reilly Eileen1ORCID,Lao Louis2,Woodhouse Braden3,Sharples Katrina4,Print Cris5,Lawrence Ben6

Affiliation:

1. Radiation Oncology Te Whatu Ora – Health New Zealand Waitaha Canterbury Christchurch New Zealand

2. Radiation Oncology, Te Whatu Ora Te Toka Tumai Auckland Waipapa Taumata Rau/The University of Auckland Auckland New Zealand

3. Cancer Trials New Zealand Waipapa Taumata Rau/The University of Auckland Auckland New Zealand

4. Cancer Trials New Zealand University of Otago Dunedin New Zealand

5. Department of Molecular Medicine and Pathology Waipapa Taumata Rau/The University of Auckland Auckland New Zealand

6. Medical Oncology, Te Whatu Ora Te Toka Tumai Auckland Waipapa Taumata Rau/The University of Auckland Auckland New Zealand

Abstract

AbstractIntroductionThe outcomes of palliative radiation therapy (RT) for neuroendocrine neoplasms (NEN) are seldom reported. We investigated outcomes following palliative radiotherapy in a cohort of patients with NENs. We hypothesised that well‐differentiated NEN will be less likely to have a clinical response than poorly differentiated NEN.MethodsPatients who received at least one course of palliative RT were identified using the New Zealand NETwork! Registry. Patients with Merkel cell carcinoma, pulmonary small cell carcinoma or asymptomatic patients were excluded. Clinical response to RT within 90 days and overall survival were analysed alongside clinical variables (fractionation, RT site, tumour differentiation and tumour primary site).ResultsThe cohort comprised 79 patients, with 147 courses of palliative RT delivered. Clinical response was measurable for 100 courses, with clinical response rate of 76%. A course delivered to a well‐differentiated NEN was associated with 2.02‐fold (95% CI 0.67, 6.12; P = 0.21) increase in odds of a clinical response compared to a poorly differentiated NEN. Median overall survival from the first fraction of RT was 94 days (95% CI 80, 138 days). Overall survival was higher in well‐differentiated NEN than in poorly differentiated NEN (HR 0.2, 95% CI 0.10–0.40, P‐value < 0.001); 30‐day mortality was 7%. There were significantly reduced odds of clinical response for non‐bone sites, and for courses >10 fractions compared to a single fraction.ConclusionPalliative RT is an appropriate option for management of symptoms in patients with both well‐ and poorly differentiated metastatic NEN.

Publisher

Wiley

Subject

Radiology, Nuclear Medicine and imaging,Oncology

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