Hypo-fractionated radiotherapy with concurrent chemotherapy for locoregional recurrence of non-small cell lung cancer after complete resection: A prospective, single-arm, phase II study (GASTO-1017)

ObjectivesTo explore the efficacy and toxicities of split-course hypo-fractionated radiotherapy with concurrent chemotherapy (HFRT−CHT) intensity modulated (IMRT) technique in non-small cell lung cancer (NSCLC) patients postoperative locoregional recurrence (LRR).Materials MethodsNSCLC were eligible if confirmed as LRR disease without distant metastasis after complete resection. HFRT−CHT using IMRT was administered 51 Gy 17 fractions or 40 10 first course followed by a break. Patients no progression persistent Grade ≥2 had second 15 5 28 7 boost. The primary endpoint progression-free survival (PFS).ResultsFifty-eight enrolled analyzed. With median follow-up 23.9 months for all, 2-year 3-year PFS rate 59.7 % 46.4 %, OS 72.5 52.2 respectively, favorable objective response 95.9 obtained whole courses protocol. 3 acute pneumonitis esophagitis occurred 2 (3.4 %) (12.1 patients, fatal reported one case (1.7 %). Exploratory subgroup analysis showed that performance status (PS) (PS 0 vs. 1: PFS, 88.1 46.9 %,P = 0.001; OS, 100 59.4 P < 0.001), site (single multiple: 93.8 47.4 0.008; 63.0 gross tumor volume (GTV) (<50cm3 ≥ 50cm3: 70.6 46.2 0.024; 85.6 57.4 0.034) significantly associated OS.ConclusionSplit-course achieved promising control satisfactory moderate NSCLC. Good PS, single GTV<50cm3 tended to have prolonged OS. Early detection may improve HFRT−CHT.