ArticleClinical lung cancer2026
An Institution-Specific Hypofractionated Radiation Therapy Regimen in the Treatment of Central and Ultracentral Non-small Cell Lung Cancer.
Article in Clinical lung cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
PURPOSE/
objectivesWhile stereotactic body radiation therapy (SBRT) or hypofractionated radiation therapy (HFRT) is routinely used to treat inoperable early-stage non-small lung cancer (esNSCLC) patients with peripheral tumors, SBRT or HFRT for central (cenT) and ultracentral tumors (UCT) remains controversial. To treat patients with tumors located within 0-2 cm of critical mediastinal structures (CMSTs), we employ an institution specific hypofractionated radiation regimen (isHFRT) with a biologically effective dose (BED) of 98.59 using 17 fractions to a dose of 6987 cGy.
methodsWe conducted a single-institution retrospective review of patients with esNSCLC treated with this isHFRT between 2011 and 2020, evaluating both tumor control rates and rates of treatment related toxicity.
resultsOf the 31 patients evaluated, 61.3% of patients had UCTs while 38.7% had cenTs. At 1- and 3 years, local control (LC) was noted to be 93.5% and 86.8% respectively. 1-year overall survival (OS) was 74.2% for all comers, 75.0% for patients with cenTs and 73.7% for patients with UCTs (p = 0.70). 3-year OS was 20.8%. Only 22.6% of patients who expired at 1-year experienced disease progression. At 12 months, adverse event free survival (AEFS) was 67.7%. While 25.8% (n = 8) of patients experienced a Grade 2 (G2) or greater toxicity, no patient experienced a G2 or greater cardiotoxicity. Only 1 patient (3.3%) experienced a Grade 5 toxicity (fatal hemoptysis 12-months following treatment). Review of the case demonstrated that the maximum tracheobronchial tree dose had been exceeded.
conclusionsOur isHFRT for patients with esNSCLC proves a safe and effective treatment for medically inoperable esNSCLC patients with cenTs and UCTs with comparable rates of toxicity when compared to prior studies.
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