Background and purpose Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy.
Materials and methods A 2-armed phase II, multi-center study was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients. Arm A received high dose radiotherapy and concurrent daily low-dose cisplatin. Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated.
Results Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months, not significantly different between arms A and B; 33.0 and 30.0 months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly associated with a shorter OS.
Discussion In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.

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Radiotherapy & Oncology
Department of Pulmonology

Walraven, I., Van Den Heuvel, M., Van Diessen, J., Schaake, E., Uyterlinde, W., Aerts, J., … Belderbos, J. (2016). Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab. Radiotherapy & Oncology, 118(3), 442–446. doi:10.1016/j.radonc.2016.02.011