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Category: Volume 05 Issue 11 November 2017
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Title: Randomized Trial Comparing the two Different Hypofractionated Radiotherapy Schedules (20Gy in 5 Fractions versus 17Gy in 2 Fractions) in Advanced Non-small Cell lung Cancer (Stage IV)

Authors: Sofi Mushtaq Ahmad, Wani Shahid Bashir, Dar Ishtiyaq Ahmad, Lone Mansoor Ul Haq, Shah Saqib Ahmad, Rasool Malik Tariq, Najmi Arshad Manzoor, Shaqul Qamar, Lone Mohd. Maqbool

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.89

Abstract

Lung cancer is a major health problem worldwide. The incidence is increasing globally at a rate of 0.5% per year. It is the leading cause of cancer mortality in most of the countries in the world1.Non-small cell lung cancer (NSCLC) accounts for at least 85% of all lung cancer cases and presenting as metastatic disease in approximately 50-60% of cases2.

Aim of the work: The aims & objectives of this study was to investigate the effectiveness and add to the evidence on the feasibility and equivalence of a two fractions versus five fractions regimen in advanced non-small cell lung cancer in terms of: Palliation of thoracic symptoms (Cough, Dyspnoea, Hemoptysis, Chest pain), Toxicities due to treatment (Immediate as well as delayed) & overall survival.

Patients and Methods: A prospective clinical study included 60 patients who were randomly assigned into two groups; group (A) 30 patients received RT regimen of 5 fractions of 4 Gy over 1 weeks to a total dose of 20 Gy, and group (B) 30 patients received RT regimen of two fractions of 8.5 Gy days 1 and 8 to a total dose of 17 Gy. All patients in the study were subjected to the following; pretreatment evaluation, Radiation treatment, patient’s assessment and overall survival.

Results: The hypofractionated RT regimens used in this study proved to be equally effective as the more protracted regimen in terms of palliation of the intrathoracic symptoms, treatment tolerance and overall survival. This may hopefully convince at some radiation oncologists still using more protracted regimens to adopt this simple and efficient treatment.

Conclusion: Short course hypofractionated radiotherapy is as good if not better than protracted hypofractinated radiotherapy for palliation in Stage IV Non-small cell Lung Cancer.

Keywords: hypofractionated, thoracic, radiotherapy, nsclc, palliation.

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Corresponding Author

Wani Shahid Bashir

SKIMS Srinagar