A phase II study of hyperfractionated accelerated radiotherapy (HART) after induction cisplatin (CDDP) and vinorelbine (VNR) for stage III non–small-cell lung cancer (NSCLC)

Purpose

The purpose was to assess the feasibility and efficacy of hyperfractionated accelerated radiotherapy (HART) after induction chemotherapy for Stage III non–small-cell lung cancer.

Methods and materials

Treatment consisted of 2 cycles of cisplatin 80 mg/m² on Day 1 and vinorelbine 25 mg/m² on Days 1 and 8 every 3 weeks followed by HART, 3 times a day (1.5, 1.8, 1.5 Gy, 4-h interval) for a total dose of 57.6 Gy.

Results

Thirty patients were eligible. Their median age was 64 years (range, 46–73 years), 24 were male, 6 were female, 8 had performance status (PS) 0, 22 had PS 1, 9 had Stage IIIA, and 21 had Stage IIIB. All but 1 patient completed the treatment. Common grade ≥3 toxicities during the treatment included neutropenia, 25; infection, 5; esophagitis, 5; and radiation pneumonitis, 3. The overall response rate was 83%. The median survival was 24 months (95% confidence interval [CI], 13–34 months), and the 2-year overall survival was 50% (95% CI, 32–68%). The median progression-free survival was 10 months (95% CI, 8–20 months).

Conclusion

Hyperfractionated accelerated radiotherapy after induction of cisplatin and vinorelbine was feasible and promising. Future investigation employing dose-intensified radiotherapy in combination with chemotherapy is needed.

Keywords:  Non–small-cell lung cancer , Hyperfractionated accelerated radiation therapy , Chemoradiotherapy