Clinical Results of Accelerated Hypofractionated Radiotherapy for Central-Type Small Lung Tumours

Purpose: We evaluated the efficacy and toxicity of accelerated hypofractionated radiotherapy (AHYPOF-RT) for central-type small lung tumours. Methods: Between November 2006 and January 2015, 40 patients with central-type small lung tumours underwent AHYPOF-RT delivered using 10 MV X-rays and a coplanar 3-field technique. The number of fractions ranged from 24 to 28, with a fraction size of 2.5–3 Gy. A total dose of 69–75 Gy to the isocentre of the planning target volume was administered to each patient. Cumulative survival and local control rates were calculated using the Kaplan–Meier method. Results: The 27 men and 13 women enrolled in the study had a median age of 79 years (range: 60−87 years). The tumour stage was T1a in 9 patients, T1b in 17 patients, and T2a in 14 patients, with a median size of 26.5 cm (range: 11–49 cm). The median follow-up period was 23 months. A complete response was achieved in 3 patients (7.5%), and a partial response, in 17 patients (42.5%). The overall 2-year and 3-year local control rates were 87.3% and 81.8% respectively; the 2-year and 3-year overall survival rates were 78.9% and 66.7% respectively. Grade 3 pneumonitis occurred in 3 patients; no other severe adverse events (≥grade 3) were observed in any patient. Conclusions: Accelerated hypofractionated radiotherapy using a fraction size of 2.5–3 Gy was highly safe and can be a more effective treatment option than conventional radiotherapy for patients with central-type small lung tumours.