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The impact of hyperfractionated radiotherapy regimen in patients with non-small cell lung cancer

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Abstract

The prognosis for patients with lung cancer is poor with an average of 5-year overall survival rate of only 10–15 % taking all clinical stages together. The aim of this study was to elucidate the impact of the radiotherapy regimen on survival. Clinical data were collected from all the Swedish Oncology Departments for 1,287 patients with a diagnosed non-small cell lung cancer (NSCLC) subjected to curatively intended irradiation (≥50 Gy) during the years 1990 to 2000. The included patients were identified based on a manual search of all medical and radiation charts at the oncology departments from which the individual patient data were collected. Patients who did not have a histopathological diagnosis date and/or death date/last follow-up date as well as patients being surgically treated were excluded from the study (n = 592). Thus, 695 patients were included in the present study. Patients who received hyperfractionated radiotherapy (HR) had a higher local control rate compared with patients receiving conventional fractionation (CF) (38 vs. 49 % local relapse). The difference in survival between the two radiotherapy regimens was statistically significant in a univariate Cox analysis (p = 0.023) in favor of HR. This significance was, however, not retained in a multivariate Cox analysis (p = 0.56). Thus, the possible beneficial effects of hyperfractionation are still unclear and need to be further investigated in well-controlled prospective clinical trials, preferably including systemic treatment with novel drugs.

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Acknowledgments

The authors would like to thank the Cancer Foundation at Gävle Hospital, The Research Fund at the Department of Oncology, Uppsala University Hospital and the Cancerfoundation, Umeå, Norrland. Also, the authors would like to thank all those who have helped with the gathering of patients and their medical charts.

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Authors and Affiliations

  1. Section of Oncology, Department of Radiology, Oncology and Radiation Sciences, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Georg Holgersson, Michael Bergqvist, Margareta Holgersson & Simon Ekman

  2. Department of Oncology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden

    Jan Nyman

  3. Department of Oncology, Gävle Hospital, 801 87, Gävle, Sweden

    Even Hoye & Stefan Bergström

  4. Department of General Oncology, Örebro University Hospital, 701 85, Örebro, Sweden

    Martin Helsing

  5. Karolinska University Hospital, 171 76, Stockholm, Sweden

    Signe Friesland

  6. Department of Oncology, Malmö University Hospital, 205 02, Malmö, Sweden

    Lars Ekberg

  7. Department of Oncology, Mälar Hospital, 631 88, Eskilstuna, Sweden

    Charlotte Mörth

  8. Department of Pulmonology, Linköping University Hospital, 581 85, Linköping, Sweden

    Thomas Blystad

  9. Department of Oncology, Lund University Hospital, 221 85, Lund, Sweden

    Sven-Börje Ewers

  10. Department of Oncology, Central Hospital, 651 82, Karlstad, Sweden

    Britta Löden

  11. Department of Radiation Sciences and Oncology, Umeå University Hospital, 901 87, Umeå, Sweden

    Roger Henriksson

  12. Department of Oncology, Entrance 78, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Georg Holgersson

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  1. Georg Holgersson
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  2. Michael Bergqvist
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  3. Jan Nyman
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  4. Even Hoye
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  5. Martin Helsing
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  7. Margareta Holgersson
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  8. Lars Ekberg
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  9. Charlotte Mörth
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  10. Simon Ekman
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  11. Thomas Blystad
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  12. Sven-Börje Ewers
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  13. Britta Löden
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  14. Roger Henriksson
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  15. Stefan Bergström
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Correspondence to Georg Holgersson.

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Holgersson, G., Bergqvist, M., Nyman, J. et al. The impact of hyperfractionated radiotherapy regimen in patients with non-small cell lung cancer. Med Oncol 30, 320 (2013). https://doi.org/10.1007/s12032-012-0320-y

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  • DOI: https://doi.org/10.1007/s12032-012-0320-y

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