Escalated dose for non-small-cell lung cancer with accelerated hypofractionated three-dimensional conformal radiation therapy

• Background and Purpose: To prospectively assess the feasibility and efficacy of a hypofractionated accelerated radiotherapy regimen (72 Gy in 24 daily fractions, 3Gy per fraction) in patients (pts) with non-resectable non-small-cell lung cancer (NSCLC). Material and Methods: We included 25 Ins with a histologically or cytologically proven NSCLC, with KPS greater than or equal to 70 and less than or equal to 10% weight loss over prior three months, and with tumour stage I/II medically inoperable (9 pts) or non-resectable stage III a/b without pleural effusion (16 pts). Eleven pts received induction chemotherapy. No more than 30% of the combined lung volume could receive more than 25 Gy and the maximal biological effective dose to the spinal cord was maintained below 44 Gy. Results: No grade-4 acute toxicity event was reported. Two pts had a treatment break because of grade-3 acute oesophagitis. Twenty-two pts were evaluable for long-term toxicity (median follow-up = 9.7 months, range 4 to 30.2 months). There were 4 Grade-1 pulmonary and 2 Grade-1 oesophageal long-term toxicity events. Twenty-two pts were evaluable for tumour response with 7 complete and 8 partial responses, 5 stable diseases and 2 progressive diseases. The actuarial 1-year overall and thoracic-progression-free survival rates were 68% and 72% respectively. Conclusions: This study demonstrates the feasibility of the experimental radiotherapy schedule, however more data are needed to confirm its efficacy. (C) 2003 Published by Elsevier Ireland Ltd.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

Keyword

non-small-cell lung cancer

three-dimensional conformal radiation

therapy

acceleration

dose escalation

hypofractionation

Publication and Content Type

art (subject category)

ref (subject category)