Comparative analysis of hypofractionated vs. conventional radiation therapy with concurrent chemotherapy in advanced inoperable non-small cell lung cancer: a retrospective study

Treatment efficacy and toxicity comparison using IMRT via VMAT in locally advanced inoperable NSCLC

Abstract

Introduction: Traditional fractionated radiation therapy is commonly used for patients with inoperable stage III non-small cell lung cancer. This study hypothesizes that accelerated hypofractionated radiotherapy could offer comparable effectiveness without increasing toxicity risks.

Materials and methods: This retrospective analysis included patients diagnosed with stage III non-small cell lung cancer between January and September 2020 who were medically or surgically inoperable, free of metastatic disease and did not receive simultaneous chemotherapy. Two treatment arms were compared: Arm A received hypofractionated radiotherapy (55Gy in 20 fractions), and Arm B received conventional fractionation (60Gy in 30 fractions). Both groups adhered to specific dose constraints for critical organs, including the spinal cord, esophagus, heart, and lungs.

Results: The study cohort consisted mainly of individuals aged 56 to 60 years, with a significant smoking history in both groups. The most common symptoms were cough, chest pain, and respiratory distress. Lesions were predominantly located in the right and left upper lobes, and adenocarcinoma was the most common histology. Despite similar performance status, differences in tumour and nodal staging affected treatment response and toxicity profiles. Acute toxicities were comparable across both treatment regimens.

Conclusion: Hypofractionated radiotherapy may be a viable treatment option for patients with inoperable stage III non-small cell lung cancer, especially those with limited performance status. These findings support the need for further research to explore the potential benefits of advanced radiation techniques in this patient population.