open access

Vol 82, No 2 (2014)
ORIGINAL PAPERS
Submitted: 2014-02-25

Hypofractionated conformal radiotherapy in combination with chemotherapy in limited disease small cell lung cancer patients

Joanna Socha, Agnieszka Guzowska, Dobromira Tyc-Szczepaniak, Aleksandra Szczęsna, Lucyna Kępka
DOI: 10.5603/PiAP.2014.0016
·
Pneumonol Alergol Pol 2014;82(2):105-115.

open access

Vol 82, No 2 (2014)
ORIGINAL PAPERS
Submitted: 2014-02-25

Abstract

Aim: To evaluate the results of hypofractionated conformal radiotherapy (RT) in limited disease small cell lung cancer (LD-SCLC) patients, with particular interest in the value of “early” RT, i.e. given before the 3rd chemotherapy (CHT) cycle.

Material and methods: Outcome of hypofractionated RT (42 Gy, 2.8 Gy/fraction, given over 19–21 days, using “concomitant boost” technique — elective volume [39 Gy, 2.6 Gy/fraction] and tumour volumes treated during the same fraction) combined with CHT in 100 consecutive LD-SCLC patients, was retrospectively assessed. The outcomes were compared with a previously published series of 117 LD-SCLC patients treated in the same institution with hyperfractionated or conventionally fractionated RT.

Results: Forty-two patients (42%) received “early” RT. Grade 3 NCI CTC acute oesophageal toxicity appeared in 5% of patients. There were three treatment-related deaths. Three-year overall survival (OS) rate was 39.4%, median — 24 months in the examined group vs. 26.0%, and 18 months in historical control, P = 0.02. Three-year OS for 78 patients with completed CHT was 42.2%, median — 28 months vs. 30%, and 14 months for 22 patients who received ≤ 3 CHT cycles, (P = 0.03). The actuarial 3-year locoregional failure risk (LRFR) was 34.0% in the examined group vs. 51.0% in the historical control, P = 0.04. Multivariate analysis showed a marginally significant correlation between the “early” use of RT and LRFR: RR = 0.43 (95% CI: 0.17–1.04), P = 0.06, with no significant impact on OS.

Conclusions: Shorter duration of RT using hypofractionation results in encouraging outcomes and acceptable toxicity. Completion of all planned CHT cycles is the most important factor for OS.

Keywords

small cell lung cancer, limited disease, hypofractionated radiotherapy, timing of radiotherapy

About this article
Title

Hypofractionated conformal radiotherapy in combination with chemotherapy in limited disease small cell lung cancer patients

Journal

Advances in Respiratory Medicine

Issue

Vol 82, No 2 (2014)

Pages

105-115

DOI

10.5603/PiAP.2014.0016

Bibliographic record

Pneumonol Alergol Pol 2014;82(2):105-115.

Keywords

small cell lung cancer
limited disease
hypofractionated radiotherapy
timing of radiotherapy

Authors

Joanna Socha
Agnieszka Guzowska
Dobromira Tyc-Szczepaniak
Aleksandra Szczęsna
Lucyna Kępka

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