Palliative chemotherapy followed by consolidation radiotherapy in patients with advanced and metastatic non-small cell lung cancer not suitable for radical treatment

Objective:This is a retrospective study to assess the effectiveness of consolidation radiotherapy (CRT) following palliative chemotherapy in patients with metastatic or locally advanced non-small cell lung cancer (NSCLC) who are not suitable for radical treatment.Methods:This study involved retrospective analysis of a prospective database of Northampton Oncology Centre from January 2005 to December 2010,63 patients with advanced/metastatic NSCLC treated at the oncology centre were enrolled.Patients were either treated with high dose (39/36 Gy /13-12 fractions,group 1) or low dose (20 Gy /5 fractions,group 2) CRT or those were not offered any CRT (group 3).Results:There was no significant difference between the three groups as regard age,sex,performance status,comorbidities or chemotherapy given.However there was a statistically significant difference as regard the stage P=0.009 with more stage IV patients at group II and III compared to group I.The mean survival for the three groups was 27 months,14 months &15 months,respectively.There was a statistically significant improvement of survival in patients treated with high dose palliative CRT compared to the other two groups (P=0.006).In multivariate analysis only the radiotherapy dose remains as the only statistical significant factor affecting the survival with hazard ratio 0.372 and confidence interval (0.147-0.726).Conclusion:Despite the limitation of our retrospective study,it is worth considering CRT approach for patients with advanced and metastatic NSCLC-not suitable for radical treatment-who have not progressed on chemotherapy.

Impact of X-radiation in the management of COVID-19 disease

Coronaviruses are a diverse group of viruses that infect both animals and humans.Even though the existence of coronavirus and its infection to humans is not new,the 2019-novel coronavirus(nCoV)caused a major burden to individuals and society i.e.,anxiety,fear of infection,extreme competition for hospitalization,and more importantly financial liability.The nCoV infection/disease diagnosis was based on non-specific signs and symptoms,biochemical parameters,detection of the virus using reverse-transcription polymerase chain reaction(RTPCR),and X-ray-based imaging.This review focuses on the consolidation of potentials of X-ray-based imaging modality[chest-X radiography(CXR)and chest computed tomography(CT)]and low-dose radiation therapy(LDRT)for screening,severity,and management of COVID-19 disease.Reported studies suggest that CXR contributed significantly toward initial rapid screening/diagnosis and CT-imaging to monitor the disease severity.The chest CT has high sensitivity up to 98%and low specificity for diagnosis and severity of COVID-19 disease compared to RT-PCR.Similarly,LDRT compliments drug therapy in the early recovery/Less hospital stays by maintaining the physiological parameters better than the drug therapy alone.All the results undoubtedly demonstrated the evidence that X-ray-based technology continues to evolve and play a significant role in human health care even during the pandemic.