title: Hypofractionated conformal radiotherapy in combination with chemotherapy in limited disease small cell lung cancer patients.
abstract: OBJECTIVE
  To evaluate the results of hypofractionated conformal radiotherapy (RT) in limited disease small cell lung cancer (LD-SCLC) patients, with particular interest in the value of "early" RT, i.e. given before the 3rd chemotherapy (CHT) cycle.
  
  
  METHODS
  Outcome of hypofractionated RT (42 Gy, 2.8 Gy/fraction, given over 19-21 days, using "concomitant boost" technique - elective volume [39 Gy, 2.6 Gy/fraction] and tumour volumes treated during the same fraction) combined with CHT in 100 consecutive LD-SCLC patients, was retrospectively assessed. The outcomes were compared with a previously published series of 117 LD-SCLC patients treated in the same institution with hyperfractionated or conventionally fractionated RT.
  
  
  RESULTS
  Forty-two patients (42%) received "early" RT. Grade 3 NCI CTC acute oesophageal toxicity appeared in 5% of patients. There were three treatment-related deaths. Three-year overall survival (OS) rate was 39.4%, median - 24 months in the examined group vs. 26.0%, and 18 months in historical control, P = 0.02. Three-year OS for 78 patients with completed CHT was 42.2%, median - 28 months vs. 30%, and 14 months for 22 patients who received ≤ 3 CHT cycles, (P = 0.03). The actuarial 3-year locoregional failure risk (LRFR) was 34.0% in the examined group vs. 51.0% in the historical control, P = 0.04. Multivariate analysis showed a marginally significant correlation between the "early" use of RT and LRFR: RR = 0.43 (95% CI: 0.17-1.04), P = 0.06, with no significant impact on OS.
  
  
  CONCLUSIONS
  Shorter duration of RT using hypofractionation results in encouraging outcomes and acceptable toxicity. Completion of all planned CHT cycles is the most important factor for OS.
authors.affiliation: sochajoanna@wp.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Socha
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Guzowska
authors.forename: Dobromira
authors.initials: D
authors.lastname: Tyc-Szczepaniak
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Szczęsna
authors.forename: Lucyna
authors.initials: L
authors.lastname: Kępka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000069473:Radiation Dose Hypofractionation; D011859:Radiography; D020266:Radiotherapy, Conformal; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome