TY - JOUR
T1 - A comparison of hypofractionated and twice-daily thoracic irradiation in limited-stage small-cell lung cancer
T2 - An overlap-weighted analysis
AU - Yan, Michael
AU - Sigurdson, Samantha
AU - Greifer, Noah
AU - Kennedy, Thomas A.C.
AU - Toh, Tzen S.
AU - Lindsay, Patricia E.
AU - Weiss, Jessica
AU - Hueniken, Katrina
AU - Yeung, Christy
AU - Sugumar, Vijithan
AU - Sun, Alexander
AU - Bezjak, Andrea
AU - John Cho, B. C.
AU - Raman, Srinivas
AU - Hope, Andrew J.
AU - Giuliani, Meredith E.
AU - Stuart, Elizabeth A.
AU - Owen, Timothy
AU - Ashworth, Allison
AU - Robinson, Andrew
AU - de Moraes, Fabio Ynoe
AU - Liu, Geoffrey
AU - Lok, Benjamin H.
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzer-land.
PY - 2021/6/2
Y1 - 2021/6/2
N2 - Despite evidence for the superiority of twice-daily (BID) radiotherapy schedules, their utilization in practice remains logistically challenging. Hypofractionation (HFRT) is a commonly implemented alternative. We aim to compare the outcomes and toxicities in limited-stage small-cell lung cancer (LS-SCLC) patients treated with hypofractionated versus BID schedules. A bi-institu-tional retrospective cohort review was conducted of LS-SCLC patients treated with BID (45 Gy/30 fractions) or HFRT (40 Gy/15 fractions) schedules from 2007 to 2019. Overlap weighting using propensity scores was performed to balance observed covariates between the two radiotherapy schedule groups. Effect estimates of radiotherapy schedule on overall survival (OS), locoregional recurrence (LRR) risk, thoracic response, any ≥grade 3 (including lung, and esophageal) toxicity were determined using multivariable regression modelling. A total of 173 patients were included in the overlap-weighted analysis, with 110 patients having received BID treatment, and 63 treated by HFRT. The median follow-up was 20.4 months. Multivariable regression modelling did not reveal any significant differences in OS (hazard ratio [HR] 1.67, p = 0.38), LRR risk (HR 1.48, p = 0.38), thoracic response (odds ratio [OR] 0.23, p = 0.21), any ≥grade 3+ toxicity (OR 1.67, p = 0.33), ≥grade 3 pneumonitis (OR 1.14, p = 0.84), or ≥grade 3 esophagitis (OR 1.41, p = 0.62). HFRT, in comparison to BID radiotherapy schedules, does not appear to result in significantly different survival, locore-gional control, or toxicity outcomes.
AB - Despite evidence for the superiority of twice-daily (BID) radiotherapy schedules, their utilization in practice remains logistically challenging. Hypofractionation (HFRT) is a commonly implemented alternative. We aim to compare the outcomes and toxicities in limited-stage small-cell lung cancer (LS-SCLC) patients treated with hypofractionated versus BID schedules. A bi-institu-tional retrospective cohort review was conducted of LS-SCLC patients treated with BID (45 Gy/30 fractions) or HFRT (40 Gy/15 fractions) schedules from 2007 to 2019. Overlap weighting using propensity scores was performed to balance observed covariates between the two radiotherapy schedule groups. Effect estimates of radiotherapy schedule on overall survival (OS), locoregional recurrence (LRR) risk, thoracic response, any ≥grade 3 (including lung, and esophageal) toxicity were determined using multivariable regression modelling. A total of 173 patients were included in the overlap-weighted analysis, with 110 patients having received BID treatment, and 63 treated by HFRT. The median follow-up was 20.4 months. Multivariable regression modelling did not reveal any significant differences in OS (hazard ratio [HR] 1.67, p = 0.38), LRR risk (HR 1.48, p = 0.38), thoracic response (odds ratio [OR] 0.23, p = 0.21), any ≥grade 3+ toxicity (OR 1.67, p = 0.33), ≥grade 3 pneumonitis (OR 1.14, p = 0.84), or ≥grade 3 esophagitis (OR 1.41, p = 0.62). HFRT, in comparison to BID radiotherapy schedules, does not appear to result in significantly different survival, locore-gional control, or toxicity outcomes.
KW - Hypofractionation
KW - Propensity score
KW - Radiotherapy
KW - Small-cell lung cancer
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U2 - 10.3390/cancers13122895
DO - 10.3390/cancers13122895
M3 - Article
C2 - 34207857
AN - SCOPUS:85107457498
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 12
M1 - 2895
ER -