The impact of overall treatment time on outcomes in radiation therapy for non-small cell lung cancer

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2000-04, Vol.28 (1), p.11-19
• Main Authors: Chen, Ming, Jiang, Guo-Liang, Fu, Xiao-Long, Wang, Li-Juan, Qian, Hao, Chen, Gui-Yuan, Zhao, Sen, Liu, Tai-Fu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - radiotherapy; Carcinoma, Non-Small-Cell Lung - secondary; Disease-Free Survival; Dose Fractionation; Female; Humans; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Neoplasm Staging; Non-small cell lung cancer; Overall treatment time; Pneumology; Radiation therapy and radiosensitizing agent; Radiotherapy; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome; Treatment with physical agents; Treatment. General aspects; Tropical medicine; Tumors; Tumors of the respiratory system and mediastinum
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/S0169-5002(99)00113-0

Purpose: A retrospective study was carried out to evaluate the impact of overall treatment time (OTT) on the results of radiation therapy for non-small cell lung cancer (NSCLC). Materials and methods: From Jan. 1990 to Dec. 1996, 256 patients with stages I–IIIb NSCLC entered this analysis. All patients received definitive radiotherapy. Biologically effective dose (BED) was used to standardize the irradiation effects. The correlation between OTT and local progression-free survival was analyzed by linear-regression and Cox proportional hazard models. The prognostic variables for survival and distant metastasis were also briefly studied. Results: OTT had been shortened in 64 patients because of an accelerated hyperfractionated irradiation, while OTT was prolonged in 114 patients due to interruptions of irradiation courses. The main causes of interruption were machine breakdown or delayed preparations of cerrobend block for boost fields (55%), holidays (11%) and treatment toxicity and side-effects (34%). Patients treated with prolonged OTT (>45 days) had significant poorer local progression-free survival than whom with OTT of ≤45 days, 1, 3 and 5 year actuarial local progression-free survivals being 49, 17 and 15% for the former, and 74, 35 and 25% for the latter, respectively ( P