This phase II study aimed to evaluate the efficacy and safety of hypofractionated involved-field radiation therapy (HypoFx-IFRT) in 2.5 Gy fractions and concurrent chemotherapy for locally advanced stage IIIA/B non-small-cell lung cancer (LA-NSCLC) without prolonging treatment delivery time beyond 6 weeks. We analyzed the overall survival (OS), progression-free survival (PFS), and safety of the treatment.
This prospective, single center, single-arm trial was initiated in 2010. All LA-NSCLC patients were treated with HypoFx-IFRT using 3-dimensional conformal radiation therapy. The median total dose of HypoFx-IFRT was 67.5 Gy (range, 60-70).
From December 2010 to October 2016, 36 patients were ultimately enrolled and evaluated. The trial was closed early due to slow accrual. The median follow-up duration was 50 months in all patients and 65 months in surviving patients. The 1-, 3-, and 5-year OS rates were 88.9% (95% confidence interval [CI], 78.6-99.2%), 61.1% (95% CI, 45.2-77.0%), and 54.1% (95% CI, 37.3-70.9%), respectively. The median time for OS was not reached. The median time for PFS was 10.7 months. The incidence rates of grade 3 radiation pneumonitis, esophagitis and esophageal stenosis were 8.3%, 2.8% and 2.8%, respectively, and no acute or late toxicities of grade 4 or 5 were observed.
This study indicated that HypoFx-IFRT with concurrent chemotherapy yielded an acceptable safety profile and might be beneficial in the survival outcomes of patients with LA-NSCLC.

Copyright © 2020. Published by Elsevier Inc.