Locally Advanced Non-Small Cell Lung Cancer: Clinical Outcome, Toxicity and Predictive Factors in Patients Treated with Hypofractionated Sequential or Exclusive Radiotherapy

Overview

Journal Curr Oncol

Publisher MDPI

Specialty Oncology

Date 2022 Jul 25

PMID 35877248

Authors

Maria Massaro

Davide Franceschini

Ruggero Spoto

Luca Dominici

Ciro Franzese

Davide Baldaccini

Beatrice Marini

Luciana Di Cristina

Marco A Marzo

Lorenzo Lo Faro

Lucia Paganini

Giacomo Reggiori

Carmela Galdieri

Alberto Testori

Marta Scorsetti

Affiliations

Soon will be listed here.

Abstract

Background: This study evaluated the outcome, toxicity and predictive factors in patients unfit for concurrent chemo-radiotherapy (CT-RT) treated with hypofractionated sequential CT-RT or exclusive radiotherapy (RT) for locally advanced non-small cell lung cancer (LA-NSCLC).

Methods: We included patients affected by LA-NSCLC (stage IIA-IVA) treated with a total dose of 50-60 Gy in 20 fractions. The primary outcomes were local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS). Univariate analysis was used to correlate outcomes with prognostic factors.

Results: Between 2011 and 2019, 210 patients were treated, 113 (53.8%) with sequential CT-RT and 97 (46.2%) with exclusive RT. After a median follow-up of 15.3 months, 74 patients (35.2%) had a local progression and 133 (63.3%) had a distant progression. The one-, two- and five-year LC were 73.6%, 55.3% and 47.9%, respectively. At the time of analysis, 167 patients (79.5%) died. The one-, two- and five-year OS were 64.7%, 36% and 20%, respectively. PTV volume correlated with PFS ( = 0.001) and LC ( = 0.005). Acute and late toxicity occurred in 82% and 26% of patients.

Conclusions: Albeit with the known limitations of a retrospective and heterogeneous study, our work shows that hypofractionated sequential CT-RT or exclusive RT offer a good local control and toxicity profile and a promising survival rate in LA-NSCLC patients unfit for the concurrent CT-RT scheme.

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