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

Bettington, C.S., Tripcony, L., Bryant, G., Hickey, B., Pratt, G. and Fay, M. (2013) 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. Journal of Medical Imaging and Radiation Oncology, 57 1: 105-112. doi:10.1111/j.1754-9485.2012.02470.x

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Author Bettington, C.S.
Tripcony, L.
Bryant, G.
Hickey, B.
Pratt, G.
Fay, M.
Title 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
Journal name Journal of Medical Imaging and Radiation Oncology   Check publisher's open access policy
ISSN 1754-9477
1754-9485
Publication date 2013-01-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/j.1754-9485.2012.02470.x
Volume 57
Issue 1
Start page 105
End page 112
Total pages 8
Place of publication Richmond, VIC, U.S.A.
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2741 Radiology Nuclear Medicine and imaging
2730 Oncology
Abstract 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 Radiation Oncology Mater Centre (ROMC) and the Royal Brisbane & Women's Hospital (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 January 2000 to July 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. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology
Keyword acceleration
dose fractionation
hypofractionation
limited stage small cell lung cancer
radiotherapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
 
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Created: Mon, 03 Feb 2014, 00:55:28 EST by Matthew Lamb on behalf of School of Medicine