Journal of Clinical Oncology, Vol 16, 3518-3523, Copyright © 1998 by American Society of Clinical Oncology
Phase II trial of hyperfractionated accelerated radiation therapy for nonresectable non-small-cell lung cancer: results of Eastern Cooperative Oncology Group 4593
MP Mehta, SP Tannehill, S Adak, L Martin, DG Petereit, H Wagner, JF Fowler and D Johnson
Department of Human Oncology, University of Wisconsin Medical School, Madison 53792-0600, USA. mehta@humonc.wisc.edu
PURPOSE: To assess the feasibility, toxicity, and efficacy of
hyperfractionated accelerated radiation therapy (HART) for non-small- cell
lung cancer (NSCLC). PATIENTS AND METHODS: Thirty patients from six
institutions with stage IIIA or IIIB NSCLC were enrolled between November
1993 and August 1995. Radiation therapy (total dose, 57.6 Gy in 36
fractions) was delivered over 15 days with the use of three daily fractions
with a 4-hour interval between fractions and an 8-hour interval between
on-cord fields. Patients were not treated on weekends. RESULTS:
Twenty-eight patients (93%) completed radiation therapy. Treatment-related
toxicities of grade 3 or greater included esophagitis in six patients and
grade 3 skin reaction in three patients. The overall objective response
rate was 54%, and the response rate within the radiation field was 64%.
With a minimum follow-up of 19 months in surviving patients, the median
survival and 1-year survival rate are 13 months and 57%, respectively. The
median relapse-free survival and 1- year relapse-free survival rate are 7
months and 23%, respectively. No transverse myelitis or late toxicities of
grade 4 or greater have been observed. CONCLUSION: HART, delivered to a
total dose of 57.6 Gy over 15 total days, is practical and well tolerated.
Survival appears similar to that seen with modern combined modality
regimens. A phase III trial is under way.
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