The Outcome of Hypofractionated Involved-Field Radiation Therapy with Concurrent Chemotherapy for the Treatment of Locally Advanced Non-Small-Cell Lung Cancer.

Abstract Purpose This phase II study aimed to evaluate the efficacy and safety of hypofractionated involved-field radiation therapy (HypoFx-IFRT) in 2.5 Gy fractions and concurrent chemotherapy for locally advanced stage IIIA/B non-small-cell lung cancer (LA-NSCLC) without prolonging treatment delivery time beyond 6 weeks. We analyzed the overall survival (OS), progression-free survival (PFS), and safety of the treatment. Methods and Materials This prospective, single center, single-arm trial was initiated in 2010. All LA-NSCLC patients were treated with HypoFx-IFRT using 3-dimensional conformal radiation therapy. The median total dose of HypoFx-IFRT was 67.5 Gy (range, 60–70). Results From December 2010 to October 2016, 36 patients were ultimately enrolled and evaluated. The trial was closed early due to slow accrual. The median follow-up duration was 50 months in all patients and 65 months in surviving patients. The 1-, 3-, and 5-year OS rates were 88.9% (95% confidence interval [CI], 78.6–99.2%), 61.1% (95% CI, 45.2–77.0%), and 54.1% (95% CI, 37.3–70.9%), respectively. The median time for OS was not reached. The median time for PFS was 10.7 months. The incidence rates of grade 3 radiation pneumonitis, esophagitis and esophageal stenosis were 8.3%, 2.8% and 2.8%, respectively, and no acute or late toxicities of grade 4 or 5 were observed. Conclusions This study indicated that HypoFx-IFRT with concurrent chemotherapy yielded an acceptable safety profile and might be beneficial in the survival outcomes of patients with LA-NSCLC.