Different fraction schedules and combinations with chemotherapy in radiation treatment of non-small cell lung cancer

Background: In locally advanced non-small cell lung cancer (NSCLC), studies demonstrating advantages with hyperfractionated accelerated radiotherapy v ersus conventional radiotherapy have been published, so have studies demons trating the value of chemotherapy concomitantly with radiotherapy. However, the value of non-conventional fractionation together with concomitant chem otherapy has nor been investigated Materials and Methods: Consecutive patie nts from a single institution were studied in a retrospective non-randomise d fashion. Inclusion criteria were stage III NSCLC, treatment with curative intent and a total dose above 50 Gy. Results: Eighty-two patients were inc luded and further divided into four different treatment groups. Multivariat e analysis indicated a survival advantage with non-conventional radiotherap y (NCRT), especially if combined with concomitant chemotherapy. Toxicity wa s feasible, however there was a trend towards higher toxicity, mainly esoph agitis, in patients given concomitant chemotherapy with NCRT. Conclusion: O ur results suggest that accelerated hyperfractionated radiotherapy with con comitant chemotherapy could be an interesting test-arm in a future prospect ive study.