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Clin Transl Oncol. 2017 Apr;19(4):440-447. doi: 10.1007/s12094-016-1544-7. Epub 2016 Aug 23.

Accelerated hypofractionated radiation therapy (AHRT) for non-small-cell lung cancer: can we leave standard fractionation?

de Dios NR1,2,3, Sanz X4,5,6, Foro P4,5,6, Membrive I4,5, Reig A4,5, Ortiz A4,5, Jiménez R4,5, Algara M4,5,6.

Author information

1
Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut Mar, c/San José de la Montaña, 12, 08024, Barcelona, Spain. nrodriguez@parcdesalutmar.cat.
2
Hospital del Mar Medical Research Institute (IMIM), Doctor Aiguader 88, 08003, Barcelona, Spain. nrodriguez@parcdesalutmar.cat.
3
Pompeu Fabra University, Doctor Aiguader 80, 08003, Barcelona, Spain. nrodriguez@parcdesalutmar.cat.
4
Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut Mar, c/San José de la Montaña, 12, 08024, Barcelona, Spain.
5
Hospital del Mar Medical Research Institute (IMIM), Doctor Aiguader 88, 08003, Barcelona, Spain.
6
Pompeu Fabra University, Doctor Aiguader 80, 08003, Barcelona, Spain.

Abstract

PURPOSE:

To report interim results from a single-institution study conducted to assess accelerated hypofractionated radiotherapy (AHRT) delivered with 3D conformal radiotherapy in two groups of patients with non-small cell lung cancer: (1) patients with early stage disease unable to tolerate surgery and ineligible for stereotactic body radiation therapy, and (2) patients with locally advanced disease unsuitable for concurrent chemoradiotherapy.

METHODS/PATIENTS:

A total of 83 patients (51 stage I-II, 32 stage III) were included. Radiotherapy targets included the primary tumor and positive mediastinal areas identified on the pre-treatment PET-CT. Mean age was 77.8 ± 7.8 years. ECOG performance status (PS) was ≥2 in 50.6 % of cases. Radiotherapy was delivered in daily fractions of 2.75 Gy to a total dose of 66 Gy (BED10 84 Gy). Acute and late toxicities were evaluated according to NCI CTC criteria.

RESULTS:

At a median follow-up of 42 months, median overall survival (OS) and cause-specific survival (CSS) were 23 and 36 months, respectively. On the multivariate analysis, PS [HR 4.14, p = 0.0001)], stage [HR 2.51, p = 0.005)], and maximum standardized uptake values (SUVmax) [HR 1.04, p = 0.04)] were independent risk factors for OS. PS [HR 5.2, p = 0.0001)] and stage [HR 6.3, p = 0.0001)] were also associated with CSS. No cases of severe acute or late treatment-related toxicities were observed.

CONCLUSIONS:

OS and CSS rates in patients treated with AHRT for stage I-II and stage III NSCLC were good. Treatment was well tolerated with no grade three or higher treatment-related toxicity. PS, stage, and SUV max were predictive for OS and CSS.

KEYWORDS:

Hypofractionation; Non-small-cell lung cancer; Performance status; Radiotherapy

PMID:
27553602
DOI:
10.1007/s12094-016-1544-7
[Indexed for MEDLINE]

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