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. 2021 Sep;39(3):202-209.
doi: 10.3857/roj.2021.00416. Epub 2021 Sep 9.

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

Ye Jin Yoo  1 , Su Ssan Kim  1 , Si Yeol Song  1 , Jong Hoon Kim  1 , Seung Do Ahn  1 , Sang-Wook Lee  1 , Sang Min Yoon  1 , Young Seok Kim  1 , Jin-Hong Park  1 , Jinhong Jung  1 , Eun Kyung Choi  1
Affiliations

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

Ye Jin Yoo et al. Radiat Oncol J. 2021 Sep.

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.

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

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Reason for hypofractionated radiotherapy.
Fig. 2.
Fig. 2.
Survival outcomes of 10-fraction hypofractionated radiotherapy: (A) freedom from local progression (FFLP), (B) disease-free survival (DFS), (C) overall survival (OS), (D) freedom from distant metastasis (FFDM).
Fig. 3.
Fig. 3.
Failure patterns of first recurrence.
See this image and copyright information in PMC

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