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

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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.

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Authors and Affiliations

  1. Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut Mar, c/San José de la Montaña, 12, 08024, Barcelona, Spain

    N. Rodríguez de Dios, X. Sanz, P. Foro, I. Membrive, A. Reig, A. Ortiz, R. Jiménez & M. Algara

  2. Hospital del Mar Medical Research Institute (IMIM), Doctor Aiguader 88, 08003, Barcelona, Spain

    N. Rodríguez de Dios, X. Sanz, P. Foro, I. Membrive, A. Reig, A. Ortiz, R. Jiménez & M. Algara

  3. Pompeu Fabra University, Doctor Aiguader 80, 08003, Barcelona, Spain

    N. Rodríguez de Dios, X. Sanz, P. Foro & M. Algara

Authors
  1. N. Rodríguez de Dios
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  2. X. Sanz
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  3. P. Foro
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  4. I. Membrive
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Correspondence to N. Rodríguez de Dios.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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de Dios, N.R., Sanz, X., Foro, P. et al. Accelerated hypofractionated radiation therapy (AHRT) for non-small-cell lung cancer: can we leave standard fractionation?. Clin Transl Oncol 19, 440–447 (2017). https://doi.org/10.1007/s12094-016-1544-7

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  • DOI: https://doi.org/10.1007/s12094-016-1544-7

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