Palliative use of ionizing radiations

Ionizing radiations, properly used, are a powerful agent for the relief of symptoms and/or signs in patients with uncontrolled cancer. Radiation therapy remains the primary treatment for patients with intracranial metastases, symptoms-producing metastases to bone, superior vena cava compression secondary to malignant tumors, spinal cord compression related to metastases, chest wall recurrence following mastectomy, mastastases to the eye or orbit threatening visual loss and a range of other less frequent problems. Although optimal time-dose patterns are still being studied, treatment should deliver a total dose likely to solve the clinical problem in the least time compatible with acceptable acute sequelae. Treatment application should be simple, accurately recorded, adapted to the comfort and convenience of the patient, and cost-effective. Radiation oncologists should appreciate the potential contributions of other methods, such as analgesic use, nerve blocks, physical medicine, behavioral modification, in order to integrate them with radiation therapy in the management plan. (orig.)