Palliative radiotherapy Radiotherapy can be used to control local tumour growth and occasionally causes regression of disease, but there is no evidence that radiotherapy alone affects survival [56] . It has, however, been shown to be helpful in the palliation of pain [57] , and approximately half the patients treated with palliative radiotherapy derive some benefit [58] . It also appears that short courses of radiotherapy (for example 20 Gy in 5 fractions) are as effective as longer courses such as 30 Gy in 10+ fractions [59] , although there is a total dose response effect [60] . Unfortunately, radiotherapy is rarely helpful in either the palliation of dyspnoea or the management of symptoms of mediastinal infiltration such as superior vena caval obstruction (SVCO), and alternative methods of treatment such as SVC stenting should be sought [11, 61] .