Hypofractionated radiation therapy in unresectable stage III non-small cell lung cancer

B J Slotman, K H Njo, A de Jonge, O W Meijer, A B Karim

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BACKGROUND: Hypofractionation is the current choice for radiation therapy for patients with unresectable non-small cell lung cancer (NSCLC) at the authors' institute.

METHODS: In this nonrandomized study, three hypofractionated radiation schedules (40-Gy split course; 30-32 Gy in 6 fractions and 24 Gy in 3 fractions) are evaluated in 301 patients with unresectable Stage III NSCLC:

RESULTS: Patients with Stage IIIA disease treated with a 40-Gy split course had longer survival (P < 0.005) and a lower local relapse rate (P < 0.01), but a higher distant failure rate (P < 0.01) than those receiving 24-32 Gy. Survival for patients with Stage IIIA disease treated with 40 Gy at 1, 2, and 5 years was 47%, 22%, and 7%, respectively. For patients with Stage IIIB disease, the radiation scheme used did not correlate with survival and relapse rates. Survival at 1, 2, and 5 years was 30%, 9%, and 2%, respectively. The hypofractionated radiation schemes were well tolerated, and no severe complications were recorded.

CONCLUSIONS: In patients with Stage IIIA disease, 40-Gy split-course radiation therapy yields survival rates comparable to those achieved with conventional radiation therapy. In patients with Stages IIIB and IV NSCLC, 24 Gy in 3 weekly fractions yields survival rates comparable to those achieved with higher total doses given in more fractions.

Original languageEnglish
Pages (from-to)1885-93
Number of pages9
Issue number6
Publication statusPublished - 15 Sept 1993


  • Adenocarcinoma/mortality
  • Adult
  • Aged
  • Carcinoma, Non-Small-Cell Lung/mortality
  • Carcinoma, Squamous Cell/mortality
  • Female
  • Humans
  • Lung Neoplasms/mortality
  • Male
  • Middle Aged
  • Radiotherapy/adverse effects
  • Time Factors
  • Treatment Outcome

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