Palliative radiation therapy in the last 30 days of life: A systematic review

Purpose To investigate the utilization of palliative radiation therapy (RT), predictors for the use of RT, and symptom palliation following RT during the last 30 days of life through systemic review of literature. Materials/methods A systematic search of available medical literature databases was performed on patients receiving palliative RT in the last 30 days of life. A total of 18 studies were evaluated. Results The overall palliative RT utilization rates during the last month of life were in the range of 5–10% among patients who died of cancer and 9–15.3% of patients who received palliative RT. The most commonly used regimen was 30 Gy in 10 fractions (36–90%). Single fraction RT utilization ranged from 0% to 59%. ECOG performance status 3–4 was significantly associated with patients receiving RT in the last 30 days of life and shorter survival. Twenty-six percent of patients who survived less than 1 month were reported to show symptom palliation following RT. Conclusion Palliative RT was performed in approximately 10% of patients who died of cancer near their end of life, with the most commonly used regimen of 30 Gy in 10 fractions. This study suggests that greater use of shorter or single fraction regimens may be beneficial, especially in patients with poor performance status.