Radiat Oncol J.  2021 Sep;39(3):202-209. 10.3857/roj.2021.00416.

Safety and efficacy of 10-fraction hypofractionated radiation therapy for non-small cell lung cancer

• Yoo YJ
• Kim SS
• Song SY
• Kim JH
• Ahn SD
• Lee Sw
• Yoon SM
• Kim YS
• Park Jh
• Jung J
• Choi EK

• KMID: 2520456
• DOI: http://doi.org/10.3857/roj.2021.00416

Abstract

Purpose
To investigate the safety and efficacy of hypofractionated radiation therapy (HFRT) in patients with non-small cell lung cancer who are unfit for surgery or stereotactic body radiation therapy (SBRT) at our institution.
Materials and Methods
From May 2007 to December 2018, HFRT was used to treat 68 lesions in 64 patients who were unsuitable for SBRT because of central tumor location, large tumor size, or contiguity with the chest wall. The HFRT schedule included a dose of 50–70 Gy delivered in 10 fractions over 2 weeks. The primary outcome was freedom from local progression (FFLP), and the secondary endpoints included overall survival (OS), disease-free survival, and toxicities.
Results
The median follow-up period was 25.5 months (range, 5.3 to 119.9 months). The FFLP rates were 79.8% and 67.8% at 1 and 2 years, respectively. The OS rates were 82.8% and 64.1% at 1 and 2 years, respectively. A larger planning target volume was associated with lower FFLP (p = 0.023). Dose escalation was not associated with FFLP (p = 0.964). Four patients (6.3%) experienced grade 3–5 pulmonary toxicities. Tumor location, central or peripheral, was not associated with either grade 3 or higher toxicity.
Conclusion
HFRT with 50–70 Gy in 10 fractions demonstrated acceptable toxicity; however, the local control rate can be improved compared with the results of SBRT. More studies are required in patients who are unfit for SBRT to investigate the optimal fractionation scheme.

Keyword

Non-small cell lung carcinomas; Radiation dose fractionation; Radiation dose hypofractionation; Treatment outcome; Toxicity