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Long-term outcome comparison for standard fractionation (59 Gy) versus hyperfractionated (45 Gy) radiotherapy plus concurrent chemotherapy for limited-stage small-cell lung cancer
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Abstract
Background
Concurrent chemoradiotherapy (CCRT) is commonly employed in limited-stage small-cell lung cancer (LS-SCLC); however, the optimal radiotherapy regimen is still unknown. This 3-institution analysis compares long-term disease control and survival outcomes for once- (QD) versus twice-daily (BID) radiotherapy at contemporary doses.
Methods and Materials
Data were collected for LS-SCLC patients treated with platinum-based CCRT and planned RT doses of >5940 cGy at >180 cGy QD or >4500 cGy at 150 cGy BID. Comparative outcome analyses were performed for treatment groups.
Results
From 2005 through 2014, 132 patients met inclusion criteria for analysis (80 QD, 52 BID). Treatment groups were well-balanced, excepting higher rate of advanced mediastinal staging, longer interval from biopsy to treatment initiation, and lower rate of prophylactic cranial irradiation for the QD group, as well as institutional practice variation. At median survivor follow-up of 33.5 months (range, 4.6–105.8), 80 patients experienced disease failure (44 QD, 36 BID), and 106 died (62 QD, 44 BID). No differences in disease control or survival were demonstrated between treatment groups.
Conclusion
The present analysis did not detect a difference in disease control or survival outcomes for contemporary dose QD versus BID CCRT in LS-SCLC.
Abstract
Background
Concurrent chemoradiotherapy (CCRT) is commonly employed in limited-stage small-cell lung cancer (LS-SCLC); however, the optimal radiotherapy regimen is still unknown. This 3-institution analysis compares long-term disease control and survival outcomes for once- (QD) versus twice-daily (BID) radiotherapy at contemporary doses.
Methods and Materials
Data were collected for LS-SCLC patients treated with platinum-based CCRT and planned RT doses of >5940 cGy at >180 cGy QD or >4500 cGy at 150 cGy BID. Comparative outcome analyses were performed for treatment groups.
Results
From 2005 through 2014, 132 patients met inclusion criteria for analysis (80 QD, 52 BID). Treatment groups were well-balanced, excepting higher rate of advanced mediastinal staging, longer interval from biopsy to treatment initiation, and lower rate of prophylactic cranial irradiation for the QD group, as well as institutional practice variation. At median survivor follow-up of 33.5 months (range, 4.6–105.8), 80 patients experienced disease failure (44 QD, 36 BID), and 106 died (62 QD, 44 BID). No differences in disease control or survival were demonstrated between treatment groups.
Conclusion
The present analysis did not detect a difference in disease control or survival outcomes for contemporary dose QD versus BID CCRT in LS-SCLC.
Keywords
Hyperfractionation; Small-Cell carcinoma; Lung neoplasms; Combined-Modality therapy; Radiotherapy.
About this articleTitle
Long-term outcome comparison for standard fractionation (59 Gy) versus hyperfractionated (45 Gy) radiotherapy plus concurrent chemotherapy for limited-stage small-cell lung cancer
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
489-493
Published online
2020-07-01
DOI
10.1016/j.rpor.2020.03.017
Bibliographic record
Rep Pract Oncol Radiother 2020;25(4):489-493.
Keywords
Hyperfractionation
Small-Cell carcinoma
Lung neoplasms
Combined-Modality therapy
Radiotherapy.
Authors
John M. Watkins
J. Kyle Russo
Nicholas Andresen
Coyt R. Rountree
Amir Zahra
Sarah L. Mott
Daniel J. Herr
Jacy O’Keefe
Bryan G. Allen
Anand K. Sharma
John M. Buatti