Multiple daily fractionation radiotherapy schedules in lung cancer
- 36 Downloads
Lung cancer is the number one worldwide cancer killer, and in spite of therapeutic advances, the overall impact on survival has remained very modest. For both small and non-small-cell lung cancer, treatment trends have shifted toward combined-modality approaches, chemotherapy for the control of systemic micrometastases, and radiotherapy for intrathoracic control. However, on both counts, rates of failure remain unacceptably high, and several novel strategies are currently being explored. The use of altered fractionation, including multiple daily fractions, reflects one approach for modifying radiotherapy. The two most common approaches are hyperfractionation and acceleration, the former designed to reduce late normal tissue toxicities and the latter to counteract accelerated tumor repopulation. Recent randomized trials suggest that such approaches may result not only in lowered rates of intrathoracic failure but also in improved survival.
KeywordsRadiat Oncol Biol Phys Radiation Therapy Oncology Group Thoracic Radiotherapy Biological Equivalent Dose Altered Fractionation
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 2.Warde P, Payne D: Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. J Clin Oncol 1992, 13:890–895.Google Scholar
- 7.JD, Pajak TF, Aspell S, et al.: Interruptions of high dose radiation therapy decrease long-term survival of favorable fatients with unresectable non-small cell carcinoma of the lung: analysis of 1,244 cases from three Radiation Therapy Oncology Group (RTOG) Trials. Int J Radiat Oncol Biol Phys 1993, 27:493–498.Google Scholar
- 8.Sause W, Scott C, Taylor S, et al.: Radiation Therapy Oncology Group (RTOG) 88-08 and Eastern Cooperative Oncology Group (ECOG) 4588: preliminary results of a phase III trial in regionally advanced unresectable non-small cell lung cancer. J Natl Cancer Inst 1995, 87:198–205.PubMedCrossRefGoogle Scholar
- 10.Saunders M, Dische S, Barrett A, et al.: Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial. CHART Steering Committee. Radiother Oncol 1999, 52:137–148. Recent report that confirms the superiority of CHART.PubMedCrossRefGoogle Scholar
- 16.Curran WJ, Scott C, Langer C, et al.: Phase III comparison of sequential vs. concurrent chemoradiation for patients with unresected stage III non small cell lung cancer: initial report of the Radiation Therapy Oncology Group (RTOG) 9410 [abstract]. Proc ASCO 2000, 19:484a. Abstract report of preliminary findings for RTOG trial.Google Scholar
- 17.Jeremic B, Shibamoto Y, Acimovic L, Milosavljevic S: Randomized trial of hyperfractionated radiation therapy with or without concurrent chemotherapy for stage III non-small cell lung cancer. J Clinic Oncol 1995, 13:452–458.Google Scholar
- 19.Turrisi AT III, Kim K, Blum R, et al.: Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 1999, 340:265–271. Report on accelerated fractionation trial that shows significantly improved overall survival compared with results for concurrent once-daily treatment, as well as improved toxicity, for limited-stage small-cell lung cancer.PubMedCrossRefGoogle Scholar
- 21.Byhardt RW, Scott C, Scott C, et al.: Response toxicity failure patterns and survival in five Radiation Therapy Oncology Group (RTOG) trials of sequential and/or concurrent chemotherapy and radiotherapy for locally advanced non-small cell carcinoma of the lung. Int J Radiat Oncol Biol Phys 1998, 42:469–478.PubMedCrossRefGoogle Scholar