Hyperthermia in the management of lung cancer. The current situation.

69S and a reduced field which encompasses all known tumor is treated on the same day as the large field two or three times per week (an interval of 4 + h is required between fractions) to total doses of 63-70.2 Gy in 5-5#{189}weeks, Acute and late reactions were found to be tolerated such that interruption of treatment (“split”) was avoided with HFX. Data suggest that acute reactions were more marked than those seen with common fractionation; late effects were equivalent to those seen with common fractionation, and there was no suggestion of increased late effects with higher total doses. AFX has also been tolerated without interruption. Toxicity with the shortest AFX regimen and tumor control rates are still undergoing evaluation. Preliminary estimates of tumor control rates and progression-free survival rates suggest that these altered fractionation regimens are at least comparable to the best results obtained in previous prospective RTOC trials with common fractionation. Definitive results in the phase 1/2 trials of HFX and AFX therapy require further observation, and comparisons with common or standard fractionation await the results of phase 3 trials. Altered fractionation schemes with systemic chemotherapy will be considered for future trials: such combinations hold promise fur major advances in the treatment of locally advanced, nonmetastatic carcinomas of the lung.