Hypofractionated accelerated radiochemotherapy with cytoprotection (Chemo-HypoARC) for inoperable non-small cell lung carcinoma.

Abstract

BACKGROUND: Concurrent radiochemotherapy and altered radiotherapy fractionation are under thorough investigation in locally advanced non-small cell lung carcinoma (NSCLC). PATIENTS AND METHODS: The efficacy and tolerance of hypofractionated accelerated radiochemotherapy supported with high dose (up to 1000 mg daily) amifostine cytoprotection (hypoARC) was examined in 31 patients. Fifteen fractions of 3.5 Gy were delivered within 28-35 days. Liposomal doxorubicin and oxaliplatin were concurrently given. RESULTS: A total of 65% of patients tolerated a daily amifostine dose of 750-1000 mg. Chemotherapy had an excellent tolerance. Grade 3 oesophagitis was noted in 7/31 (22.5%) patients. Radiation pneumonitis was absent and radiation fibrosis minimal. Complete and partial response were observed in 12/31 (38.6%) and 17/31 (54.8%) patients, respectively. The 2-year estimated local progression-free and overall survival interval were 58% and 45%, respectively. CONCLUSION: Given the simplicity of HypoARC, the very low morbidity, and the high complete response and survival rates obtained, HypoARC regimens deserve further testing.