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Accelerated fractionation regimens in radiotherapy of inoperable non-small-cell lung cancer
Authors:Val'kov M Iu  Zolotkov A G  Mardynskiĭ Iu S  Asakhin S M  Kudriavtsev L V  Akishin V A
Affiliation:Northern State Medical University, Arkhangelsk.
Abstract:The results of definitive radiation treatment (1988-2000) for 375 patients with inoperable non-small cell lung cancer were analyzed. Three regimens of fractionation were used: (1) accelerated fractionation (AF)--(133), 2.5 Gy, 3 days a week, to a total of 47.5--55 Gy; (2) accelerated hyperfractionation (AHF)--(93), 1.25 Gy, daily, to a total of 60-72.5 Gy and standard fractionation (SF)--(149), 2 Gy, daily, to a total of 58-68 Gy. The advantages of AHF were established as regards complete regression rate (54.9% vs. 18.6%--SF and 18.1%--AF; p(0.001), median survival (30.5(2.4 months vs. 18.9 (1%--SF (p = 0.004) and 20.4 (2.4--AF (p = 0.004)), and 3-year survival (36.6% vs. 16.7%--SF (p = 0.005) and 15.5%--AF (p = 0.005). 17.9%, 9.0% (p = 0.11) and 8.1% (p = 0.08) have survived, respectively. Overall survival in the AHF group was superior in stages IIB--III; in stage I, the results were identical. Immediate response to radical radiotherapy appeared the only statistically significant factor of survival (p = 0.005-0.008) in all the groups.
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