title: Hypofractionated radiotherapy for medically inoperable stage I non-small cell lung cancer.
abstract: BACKGROUND
  To investigate the clinical outcomes and toxicity of hypofractionated radiotherapy for medically inoperable stage I non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Patients treated with radiotherapy at a dose of 4-6 Gy per fraction using fixed-field intensity modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT) at our hospital from June 2005 to December 2013 were analyzed. The total prescription doses ranged from 50-78 Gy with 4-6 Gy per fraction. The median follow-up period was 24 months.
  
  
  RESULTS
  A total of 65 patients with stage I NSCLC were analyzed, including 43 primary NSCLC patients and 22 patients with recurrent or second primary NSCLC. An objective response (complete or partial response) was achieved at six months in 84.6% of patients. The three-year local control rate was 90.8%. Kaplan-Meier estimates of local failure-free, progression-free, overall, and cancer-specific survival rates at three years were 90.3%, 64.3%, 68.9%, and 88.8%, respectively. The rate of symptomatic radiation pneumonitis was 16.9%, and no grade 4-5 toxicity was observed.
  
  
  CONCLUSIONS
  Favorable local control and outcome was achieved with hypofractionated radiotherapy in patients with inoperable stage I NSCLC with acceptable toxicity. The most common schedule of 6 Gy × 12 fractions may be a promising regimen, and a prospective study is in process.
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Jian-Yang
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Jing-Bo
authors.initials: JB
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Zhou-Guang
authors.initials: ZG
authors.lastname: Hui
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Xiao-Zhen
authors.initials: XZ
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Zong-Mei
authors.initials: ZM
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology Cancer Hospital & Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
authors.forename: Lu-Hua
authors.initials: LH
authors.lastname: Wang
keywords: Dose fractionation; non‐small cell lung cancer; outcome