Efficacy and Safety of Four Weeks of Moderately Hypofractionated Chemoradiation for Unresectable, Stage 3 Non-Small Cell Lung Cancer: A Systematic Review

Ludbrook, JJ; Kumar, M; Soon, YY; Smith, A; Mallesara, G; Hau, E; Hegi-Johnson, F; Vinod, S

Author(s): Ludbrook, JJ; Kumar, M; Soon, YY; Smith, A; Mallesara, G; Hau, E; Hegi-Johnson, F; Vinod, S;
Details: Publication Year 2025-08,Volume 21,Issue #4,Page 359-367
Journal Title: Asia-Pacific Journal of Clinical Oncology
Publication Type: Review
Abstract: Shortening treatment time with moderately hypofractionated radiotherapy benefits patients by reducing inconvenience and costs, but its use in the definitive treatment of unresectable Stage 3 non-small cell lung cancer is controversial due to lack of level one evidence and toxicity concerns. Pivotal systemic therapy trials utilize conventionally fractionated chemoradiation at 2 Gy per fraction given over 6 weeks. In practice, 4 weeks of chemoradiation at 2.75 Gy per fraction is sometimes employed to reduce the treatment burden for selected patients, especially those who are older or have comorbidities. It is uncertain if the two fractionation regimens are similar in biological effectiveness, especially with varying systemic therapy. This systematic review aimed to collate the survival and toxicity outcomes for 4 weeks of moderately hypofractionated chemoradiation, using > 50 -60 Gy in 20 fractions. Eight studies met the eligibility criteria; seven studies were from a database search of MEDLINE, EMBASE, Cochrane Library, and Web of Science and one study was added later. Two studies were prospective randomized trials and six were retrospective cohort studies. No study included immunotherapy. The historical evidence has been limited, but emerging data is promising, especially when compared to outcomes of standard chemoradiation. Thus, further investigation of this strategy is justified.
Publisher: Wiley
Keywords: Humans; *Carcinoma, Non-Small-Cell Lung/pathology/therapy/drug therapy/radiotherapy; *Lung Neoplasms/pathology/therapy/drug therapy/radiotherapy; *Chemoradiotherapy/methods/adverse effects; *Radiation Dose Hypofractionation; Neoplasm Staging; Treatment Outcome; chemoradiation; locally advanced; moderately hypofractionated; non–small cell lung cancer; unresectable
Department(s): Radiation Oncology
Publisher's Version: https://doi.org/10.1111/ajco.14152
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-02-04 07:05:30

Last Modified: 2025-07-31 02:10:26