Meta-analysis of palliative radiation for lung cancer

Journal of Clinical Oncology has a meta-analysis of palliative radiation for lung cancer.  It looks at controlled trials comparing different dosing schedules of radiation with palliative-intent for patients with incurable lung cancer.  Briefly, it confirmed that lower-dose radiation is just as effective for symptom palliation than higher-dose radiation (hemoptysis, pain, cough, etc.).  This analysis suggests that 1 year survival is modestly improved for patients with higher-dose regimens (by ~5% overall).  What I found most interesting was just the simple, natural history information the review provided regarding symptoms (e.g. ~50% of patients had complete resolution of their chest pain after radiation, 30% had complete resolution of cough, etc.).  

The same issue has a hilarious Art of Oncology piece about 'the difficult patient.'  Short, touching, and worth a read, and I practically choked on my apple when the author mentioned this 'nightmare' patient getting a tattoo while neutropenic.