title: Once-daily radiotherapy to > or =59.4 Gy versus twice-daily radiotherapy to > or =45.0 Gy with concurrent chemotherapy for limited-stage small-cell lung cancer: a comparative analysis of toxicities and outcomes.
abstract: OBJECTIVE
  The aim of this study was to compare toxicities, disease control, survival outcomes, and patterns of failure between groups of limited-stage small-cell lung cancer patients treated with once-daily versus twice-daily radiotherapy and concurrent chemotherapy.
  
  
  METHODS
  This single-institution retrospective analysis included a comparison of two of radiotherapy regimens to planned doses of (1) > or =59.4 Gy at 1.8-2.0 Gy per once-daily fraction or (2) > or =45 Gy at 1.5 Gy per twice-daily fractions with concurrent platinum-based chemotherapy. Comparative analyses of toxicities and disease control were performed.
  
  
  RESULTS
  A total of 71 patients were included in the present study (17 once-daily, 54 twice-daily). Patient, tumor, staging, and treatment factors were similar between the two treatment groups. Median planned radiotherapy doses were 60 Gy (range 59.4-70.0 Gy) and 45 Gy (range 45-51 Gy) for the once-daily and twice-daily groups, respectively. Acute toxicities were similar between the groups ( approximately 20% grade 3 esophagitis). At a median survival follow-up of 26.2 months (range 3.4-85.5 months), 42 patients had died. The 2-year overall survival estimates were similar at 43% and 49% for the once-daily versus twice-daily groups, respectively. Isolated in-field failures were similar between the two groups ( approximately 17%).
  
  
  CONCLUSIONS
  The present analysis did not detect a statistically significant difference in acute toxicities, disease control, or survival outcomes in limited-stage small-cell lung cancer patients treated with concurrent chemotherapy and once-daily versus twice-daily radiotherapy.
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Watkins
authors.forename: John A
authors.initials: JA
authors.lastname: Fortney
authors.forename: Amy E
authors.initials: AE
authors.lastname: Wahlquist
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shirai
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Garrett-Mayer
authors.forename: Eric G
authors.initials: EG
authors.lastname: Aguero
authors.forename: Carol A
authors.initials: CA
authors.lastname: Sherman
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Turrisi
authors.forename: Anand K
authors.initials: AK
authors.lastname: Sharma
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage / Q000592:standards; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome