title: Comparison of once and twice daily radiotherapy for limited stage small-cell lung cancer.
abstract: OBJECTIVE
  This study was designed to review outcomes of once- (QD) versus twice-daily (BID) radiotherapy (RT) for limited stage small-cell lung cancer (L-SCLC) treated at Dana-Farber Cancer Institute/Brigham and Women's Hospital.
  
  
  METHODS
  We reviewed records for all patients with L-SCLC treated with radical chemoradiotherapy at our institution between January 2005 and December 2010. Differences in patient, tumor, and treatment characteristics were assessed by Student's t test and Fisher exact test. Outcomes were compared using Kaplan-Meier estimates and Cox proportional hazards regression.
  
  
  RESULTS
  Twenty patients received QD RT to a median dose of 61.2 Gy, and 26 patients received BID RT to a dose of 45 Gy. Median follow-up was 2.8 years. Overall survival (OS) was similar in both groups. 5-year locoregional control (LC) for all patients was 67 %: 80 % for the QD group and 57 % for the BID group (log-rank, P = 0.16). Grade 2 or higher dermatitis and pneumonitis were significantly higher in the QD group (15 vs. 0 %, P = 0.0014 and 13 vs. 4 %, P = 0.048, respectively), whereas Grade 2 or higher esophagitis trended higher in the BID group (44 vs. 24 %, P = 0.076).
  
  
  CONCLUSIONS
  Although there were no differences in OS with QD versus BID RT, there was a trend toward increased LC in the QD group. Dermatitis and pneumonitis were more common for QD RT, and esophagitis was somewhat more common for BID RT. Possible differences in toxicities depending on RT regimen may be worth further investigation, until results from CALGB 30610 become available.
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, 450 Brookline Avenue, Boston, MA, 02215, USA, agazula@umich.edu.
authors.forename: Abhilash
authors.initials: A
authors.lastname: Gazula
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Baldini
authors.forename: Aileen
authors.initials: A
authors.lastname: Chen
authors.forename: David
authors.initials: D
authors.lastname: Kozono
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004941:Esophagitis / Q000209:etiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D017564:Radiation Pneumonitis / Q000209:etiology; D011855:Radiodermatitis / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D013997:Time Factors; D016896:Treatment Outcome