Results of a preliminary study using hypofractionated involved-field radiation therapy and concurrent carboplatin/paclitaxel in the treatment of locally advanced non-small-cell lung cancer

We aimed to evaluate the feasibility and efficacy of hypofractionated involved-field radiation therapy (IFRT) omitting elective nodal irradiation (ENI) with concurrent chemotherapy for locally advanced non-small-cell lung cancer (NSCLC). Between July 2004 and July 2006, ten patients with locally advanced NSCLC were included in this study. One had stage IIIA and 9 had stage IIIB disease. The treatment consisted of IFRT in fractions of 2.5 Gy and weekly carboplatin (CBDCA)/paclitaxel (PTX). Hypofractionated IFRT with a median total dose of 65 Gy with median percent total lung volume exceeding 20 Gy (V20) of 20.2%, and a median of five courses of chemotherapy with weekly CBDCA (area under the curve, 1.5-2.0)/PTX (30-35 mg/m(2)) were given to all patients. The median survival time and the 1-, 2-, and 3-year overall survival rates were 29.5 months and 90.0%, 58.3%, and 43.8%, respectively. No elective nodal failure was encountered during the median follow up of 18.2 months. No acute or late toxicities of grade 3 or worse were observed. No in-field recurrence occurred in the group with a total dose of 67.5 Gy or more, but there was such recurrence in 83.3% of those in the group with less than 67.5 Gy. Hypofractionated IFRT with weekly CBDCA/PTX was a feasible treatment regimen. Hypofractionated IFRT with a total dose of 67.5 Gy or more could be a promising modality to improve the treatment results in patients with locally advanced NSCLC.