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Patient Selection and Outcomes for Hypofractionated Accelerated Radiation and Concurrent Chemotherapy for
Caressa Hui1, Cesar Marquez1, Brianna Lau1
1Department of Radiation Oncology, Stanford University, Stanford, CA.
Clinical Lung Cancer
|December 8, 2023
Summary
Hypofractionated accelerated radiation therapy (HART) with chemotherapy shows promising results for select non-small cell lung cancer patients, demonstrating reduced toxicity and improved local control compared to standard therapy.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Hypofractionated accelerated radiation therapy (HART) with concurrent chemotherapy adoption is hindered by toxicity concerns.
- Optimizing HART requires careful patient selection and dosimetric evaluation for organs at risk.
Purpose of the Study:
- To evaluate the outcomes of patients treated with HART and concurrent chemotherapy.
- To assess dosimetric parameters to organs at risk to guide patient selection for HART.
Main Methods:
- Retrospective analysis of non-small cell lung cancer (NSCLC) patients treated with HART or standard fractionated radiation therapy (SFRT) with concurrent chemotherapy.
- Comparison of dosimetric parameters, toxicity rates (pneumonitis, esophagitis), recurrence patterns, and survival between HART and SFRT cohorts.
Main Results:
- HART patients received a median dose of 2.75 Gy per fraction.
- HART was associated with significantly lower doses to the lung, heart, and esophagus, leading to favorable rates of esophagitis (20.8% vs. 45%, P < .01).
- The HART cohort showed a trend towards lower in-field recurrence (7.6% vs. 23.1%, P = .058) and met proposed lung constraints.
Conclusions:
- Definitive HART with concurrent chemotherapy can achieve excellent local control with low toxicity in select NSCLC patients with favorable organ-at-risk dosimetry.
- These findings support further investigation in a prospective study for HART in NSCLC.
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