Hypofractionated palliative radiotherapy (17Gy per two fractions) in advanced non-small-cell lung carcinoma is comparable to standard fractionation for symptom control and survival: A national phase III trial

S. Sundstrøm, R. Bremnes, U. Aasebø, S. Aamdal, R. Hatlevoll, P. Brunsvig, D. C. Johannessen, O. Klepp, Peter Fayers, S. Kaasa

Research output: Contribution to journalArticle

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Abstract

Purpose To investigate whether the effect of hypofractionated thoracic radiotherapy (TRT) is comparable to more standard fractionated radiotherapy (RT) in advanced non-small-cell lung cancer (NSCLC).

Patients and Methods A total of 421 patients with locally advanced stage III or stage IV NSCLC tumors were included. Inclusion criteria were inoperable, disease too advanced for curative radiotherapy, and chest symptoms or central tumor threatening the airways. Patients were randomly assigned to three arms: A, 17 Gy per two fractions (n = 146); B, 42 Gy per 15 fractions (n = 145); and C, 50 Gy per 25 fractions (n = 130). Four hundred seven patients were eligible for the study; 395 patients (97%) participated in the health-related quality-of-life (HRQOL) study. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (OLQ)-C30 and EORTC QLQ-Iung cancer-specific module (LC13) were used to investigate airway symptom relief and changes in HRQOL. Assessments were performed before TRT and until week 54. Clinicians' assessments of symptom improvement were at 2, 6, and 14 weeks after completion of TRT. The patients were observed for a minimum of 3 years.

Results Baseline prognostic data were equally distributed in the treatment groups. Patient compliance with respect to the HRQOL investigation was minimum 74%. HRQOL and symptom relief were equivalent in the treatment arms. No significant difference in survival among arms A, B, and C was found, with median survival 8.2, 7.0, and 6.8 months, respectively.

Conclusion Our data indicate that protracted palliative TRT renders no improvement in symptom relief, HRQOL, or survival when compared with short-term hypofractionated treatment in advanced NSCLC.

(C) 2004 by American Society of Clinical Oncology.

Original languageEnglish
Pages (from-to)801-810
Number of pages10
JournalJournal of Clinical Oncology
Volume22
Issue number5
DOIs
Publication statusPublished - Mar 2004

Keywords

  • QUALITY-OF-LIFE
  • CLINICAL-TRIALS
  • QUESTIONNAIRE QLQ-C30
  • INOPERABLE CARCINOMA
  • CANCER
  • RADIATION
  • SCORES
  • SINGLE
  • CARE

Cite this

Hypofractionated palliative radiotherapy (17Gy per two fractions) in advanced non-small-cell lung carcinoma is comparable to standard fractionation for symptom control and survival: A national phase III trial. / Sundstrøm, S.; Bremnes, R.; Aasebø, U.; Aamdal, S.; Hatlevoll, R.; Brunsvig, P.; Johannessen, D. C.; Klepp, O.; Fayers, Peter; Kaasa, S.

In: Journal of Clinical Oncology, Vol. 22, No. 5, 03.2004, p. 801-810.

Research output: Contribution to journalArticle

Sundstrøm, S. ; Bremnes, R. ; Aasebø, U. ; Aamdal, S. ; Hatlevoll, R. ; Brunsvig, P. ; Johannessen, D. C. ; Klepp, O. ; Fayers, Peter ; Kaasa, S. / Hypofractionated palliative radiotherapy (17Gy per two fractions) in advanced non-small-cell lung carcinoma is comparable to standard fractionation for symptom control and survival: A national phase III trial. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 5. pp. 801-810.
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title = "Hypofractionated palliative radiotherapy (17Gy per two fractions) in advanced non-small-cell lung carcinoma is comparable to standard fractionation for symptom control and survival: A national phase III trial",
abstract = "Purpose To investigate whether the effect of hypofractionated thoracic radiotherapy (TRT) is comparable to more standard fractionated radiotherapy (RT) in advanced non-small-cell lung cancer (NSCLC).Patients and Methods A total of 421 patients with locally advanced stage III or stage IV NSCLC tumors were included. Inclusion criteria were inoperable, disease too advanced for curative radiotherapy, and chest symptoms or central tumor threatening the airways. Patients were randomly assigned to three arms: A, 17 Gy per two fractions (n = 146); B, 42 Gy per 15 fractions (n = 145); and C, 50 Gy per 25 fractions (n = 130). Four hundred seven patients were eligible for the study; 395 patients (97{\%}) participated in the health-related quality-of-life (HRQOL) study. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (OLQ)-C30 and EORTC QLQ-Iung cancer-specific module (LC13) were used to investigate airway symptom relief and changes in HRQOL. Assessments were performed before TRT and until week 54. Clinicians' assessments of symptom improvement were at 2, 6, and 14 weeks after completion of TRT. The patients were observed for a minimum of 3 years.Results Baseline prognostic data were equally distributed in the treatment groups. Patient compliance with respect to the HRQOL investigation was minimum 74{\%}. HRQOL and symptom relief were equivalent in the treatment arms. No significant difference in survival among arms A, B, and C was found, with median survival 8.2, 7.0, and 6.8 months, respectively.Conclusion Our data indicate that protracted palliative TRT renders no improvement in symptom relief, HRQOL, or survival when compared with short-term hypofractionated treatment in advanced NSCLC.(C) 2004 by American Society of Clinical Oncology.",
keywords = "QUALITY-OF-LIFE, CLINICAL-TRIALS, QUESTIONNAIRE QLQ-C30, INOPERABLE CARCINOMA, CANCER, RADIATION, SCORES, SINGLE, CARE",
author = "S. Sundstr{\o}m and R. Bremnes and U. Aaseb{\o} and S. Aamdal and R. Hatlevoll and P. Brunsvig and Johannessen, {D. C.} and O. Klepp and Peter Fayers and S. Kaasa",
note = "Acknowledgment This study was initiated and performed by The Norwegian Lung Cancer Study Group. The secretarial assistance at the Clinical Research Office, The University Hospital of Trondheim, is greatly appreciated.",
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TY - JOUR

T1 - Hypofractionated palliative radiotherapy (17Gy per two fractions) in advanced non-small-cell lung carcinoma is comparable to standard fractionation for symptom control and survival: A national phase III trial

AU - Sundstrøm, S.

AU - Bremnes, R.

AU - Aasebø, U.

AU - Aamdal, S.

AU - Hatlevoll, R.

AU - Brunsvig, P.

AU - Johannessen, D. C.

AU - Klepp, O.

AU - Fayers, Peter

AU - Kaasa, S.

N1 - Acknowledgment This study was initiated and performed by The Norwegian Lung Cancer Study Group. The secretarial assistance at the Clinical Research Office, The University Hospital of Trondheim, is greatly appreciated.

PY - 2004/3

Y1 - 2004/3

N2 - Purpose To investigate whether the effect of hypofractionated thoracic radiotherapy (TRT) is comparable to more standard fractionated radiotherapy (RT) in advanced non-small-cell lung cancer (NSCLC).Patients and Methods A total of 421 patients with locally advanced stage III or stage IV NSCLC tumors were included. Inclusion criteria were inoperable, disease too advanced for curative radiotherapy, and chest symptoms or central tumor threatening the airways. Patients were randomly assigned to three arms: A, 17 Gy per two fractions (n = 146); B, 42 Gy per 15 fractions (n = 145); and C, 50 Gy per 25 fractions (n = 130). Four hundred seven patients were eligible for the study; 395 patients (97%) participated in the health-related quality-of-life (HRQOL) study. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (OLQ)-C30 and EORTC QLQ-Iung cancer-specific module (LC13) were used to investigate airway symptom relief and changes in HRQOL. Assessments were performed before TRT and until week 54. Clinicians' assessments of symptom improvement were at 2, 6, and 14 weeks after completion of TRT. The patients were observed for a minimum of 3 years.Results Baseline prognostic data were equally distributed in the treatment groups. Patient compliance with respect to the HRQOL investigation was minimum 74%. HRQOL and symptom relief were equivalent in the treatment arms. No significant difference in survival among arms A, B, and C was found, with median survival 8.2, 7.0, and 6.8 months, respectively.Conclusion Our data indicate that protracted palliative TRT renders no improvement in symptom relief, HRQOL, or survival when compared with short-term hypofractionated treatment in advanced NSCLC.(C) 2004 by American Society of Clinical Oncology.

AB - Purpose To investigate whether the effect of hypofractionated thoracic radiotherapy (TRT) is comparable to more standard fractionated radiotherapy (RT) in advanced non-small-cell lung cancer (NSCLC).Patients and Methods A total of 421 patients with locally advanced stage III or stage IV NSCLC tumors were included. Inclusion criteria were inoperable, disease too advanced for curative radiotherapy, and chest symptoms or central tumor threatening the airways. Patients were randomly assigned to three arms: A, 17 Gy per two fractions (n = 146); B, 42 Gy per 15 fractions (n = 145); and C, 50 Gy per 25 fractions (n = 130). Four hundred seven patients were eligible for the study; 395 patients (97%) participated in the health-related quality-of-life (HRQOL) study. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (OLQ)-C30 and EORTC QLQ-Iung cancer-specific module (LC13) were used to investigate airway symptom relief and changes in HRQOL. Assessments were performed before TRT and until week 54. Clinicians' assessments of symptom improvement were at 2, 6, and 14 weeks after completion of TRT. The patients were observed for a minimum of 3 years.Results Baseline prognostic data were equally distributed in the treatment groups. Patient compliance with respect to the HRQOL investigation was minimum 74%. HRQOL and symptom relief were equivalent in the treatment arms. No significant difference in survival among arms A, B, and C was found, with median survival 8.2, 7.0, and 6.8 months, respectively.Conclusion Our data indicate that protracted palliative TRT renders no improvement in symptom relief, HRQOL, or survival when compared with short-term hypofractionated treatment in advanced NSCLC.(C) 2004 by American Society of Clinical Oncology.

KW - QUALITY-OF-LIFE

KW - CLINICAL-TRIALS

KW - QUESTIONNAIRE QLQ-C30

KW - INOPERABLE CARCINOMA

KW - CANCER

KW - RADIATION

KW - SCORES

KW - SINGLE

KW - CARE

U2 - 10.1200/JCO.2004.06.123

DO - 10.1200/JCO.2004.06.123

M3 - Article

VL - 22

SP - 801

EP - 810

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 5

ER -