Effects of hyperfractionated radiotherapy versus hypofractionated radiotherapy combined with concurrent chemotherapy on prognosis of limited-stage small-cell lung cancer
10.3760/cma.j.issn.1004-4221.2017.09.005
- VernacularTitle:局限期SCLC超分割或大分割放疗同步化疗预后比较
- Author:
Xiao HU
;
Bing XIA
;
Yong BAO
;
Yujin XU
;
Jin WANG
;
Honglian MA
;
Ying JIN
;
Min FANG
;
Huarong TANG
;
Mengyuan CHEN
;
Baiqiang DONG
;
Xiaolong FU
;
Ming CHEN
- Keywords:
Lung neoplasms/radiotherapy;
Radiotherapy;
intensity-modulated;
Radiotherapy;
hyperfractionation;
Radiotherapy;
large fractionation;
Lung neoplasms/chemotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2017;26(9):1000-1005
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of hyperfractionated radiotherapy versus hypofractionated radiotherapy combined with concurrent chemotherapy on the prognosis of limited-stage small-cell lung cancer (SCLC).Methods A total of 188 patients with limited-stage SCLC were enrolled in this study and divided into hyperfractionated group (n=92) and hypofractionated group (n=96).The hyperfractionated group received thoracic radiotherapy at 45 Gy in 30 fractions twice a day, while the hypofractionated group received 55 Gy in 22 fractions once a day.The Kaplan-Meier method was used to calculate survival rates, and the Cox model was used for multivariate prognostic analysis.Results There were not significant differences in 1-, 2-, and 5-year progression-free survival (PFS) rates and 1-, 2-, and 5-year overall survival (OS) rates between the hyperfractionated group and the hypofractionated group (82% vs.85%, 61% vs.69%, 59% vs.69%, P=0.27;85% vs.77%, 41% vs.34%, 27% vs.27%, P=0.37).The multivariate analysis showed that the time from the initiation of chemotherapy to the initiation of thoracic radiotherapy ≤43 days was favorable prognostic factor for PFS (P=0.005).The time from the initiation of chemotherapy to the end of thoracic radiotherapy ≤63 days and prophylactic cranial irradiation were favorable prognostic factors for OS (P=0.044;P=0.000).There were significant differences in incidence rates of grade 2 and 3 acute radiation esophagitis between the two groups (28% vs.16%, 9% vs.2%, P=0.009).Conclusions Both hyperfractionated radiotherapy and hypofractionated radiotherapy combined with chemotherapy can improve the PFS and OS of patients with limited-stage SCLC.The time from the initiation of chemotherapy to the initiation of thoracic radiotherapy ≤43 days and the time from the initiation of chemotherapy to the end of thoracic radiotherapy ≤63 days are favorable prognostic factors for PFS and OS, respectively.However, the hyperfractionated group has significantly higher incidence rates of grade 2 and 3 acute radiation esophagitis than the hypofractionated group.
