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A retrospective analysis of survival outcomes for two different radiotherapy fractionation schedules given in the same overall time for limited stage small cell lung cancer
Author(s) -
Bettington Catherine S,
Tripcony Lee,
Bryant Guy,
Hickey Brigid,
Pratt Gary,
Fay Michael
Publication year - 2013
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2012.02470.x
Subject(s) - medicine , radiation therapy , prophylactic cranial irradiation , lung cancer , conventional pci , stage (stratigraphy) , chemotherapy , multivariate analysis , retrospective cohort study , survival analysis , surgery , dose fractionation , paleontology , myocardial infarction , biology
Purpose To compare survival outcomes for two fractionation schedules of thoracic radiotherapy, both given over 3 weeks, in patients with limited stage small cell lung cancer ( LS‐SCLC ). Methods and Materials At R adiation O ncology M ater C entre ( ROMC ) and the R oyal B risbane & W omen's H ospital ( RBWH ), patients with LS‐SCLC treated with curative intent are given radiotherapy (with concurrent chemotherapy) to a dose of either 40 Gy in 15 fractions (‘the 40 Gy /15# group’) or 45 Gy in 30 fractions (‘the 45 Gy /30# group’). The choice largely depends on institutional preference. Both these schedules are given over 3 weeks, using daily and twice‐daily fractionation respectively. The records of all such patients treated from J anuary 2000 to J uly 2009 were retrospectively reviewed and survival outcomes between the two groups compared. Results Of 118 eligible patients, there were 38 patients in the 40 Gy /15# group and 41 patients in the 45 Gy /30# group. The median relapse‐free survival time was 12 months in both groups. Median overall survival was 21 months (95% CI 2–37 months) in the 40 Gy /15# group and 26 months (95% CI 1–48 months) in the 45 Gy /30# group. The 5‐year overall survival rates were 20% and 25%, respectively ( P = 0.24). On multivariate analysis, factors influencing overall survival were: whether prophylactic cranial irradiation ( PCI ) was given ( P = 0.01) and whether salvage chemotherapy was given at the time of relapse ( P = 0.057). Conclusions Given the small sample size, the potential for selection bias and the retrospective nature of our study it is not possible to draw firm conclusions regarding the efficacy of hypofractionated thoracic radiotherapy compared with hyperfractionated accelerated thoracic radiotherapy however hypofractionated radiotherapy may result in equivalent relapse‐free survival.