PMID- 37004334
OWN - NLM
STAT- MEDLINE
DCOM- 20230407
LR  - 20230407
IS  - 1724-191X (Electronic)
IS  - 1120-1797 (Linking)
VI  - 108
DP  - 2023 Apr
TI  - Feasibility and safety of shortened hypofractionated high-dose palliative lung 
      radiotherapy - A retrospective planning study.
PG  - 102559
LID - S1120-1797(23)00036-4 [pii]
LID - 10.1016/j.ejmp.2023.102559 [doi]
AB  - OBJECTIVE: Assess the safety and feasibility of shortened hypofractionated 
      high-dose palliative lung radiotherapy in a retrospective planning study. 
      METHODS: Fifteen late stage (III or IV) NSCLC lung radiotherapy patients 
      previously treated with the standard palliative 36 Gy in 12 fractions (12F) 
      schedule were non-randomly selected to achieve a representative distribution of 
      tumour sizes, volumes, and location. Plans were produced using 30 Gy in 5 
      fractions (5F) and 6 fractions (6F) using a 6MV FFF co-planar VMAT technique. 
      Plans were optimised to meet dose-constraints for planning target volumes (PTVs) 
      and organs at risk (OARs) with established OAR constraints expressed as 
      biological equivalent doses (BEDs). The potential safety was assessed using these 
      BEDs and also with reductions of 10% (BED-10%) and 20% (BED-20%) to account for a 
      reduction in tolerance doses from the effects of chemotherapy or surgery. 
      RESULTS: Mandatory BED constraints were met for all fifteen 5F and 6F plans; 
      BED-10% constraints were met by all 6F plans and six 5F plans. BED-20% 
      constraints were met by six 6F and three 5F respectively. CONCLUSION: It is 
      potentially safe and feasible to deliver high-dose palliative radiotherapy for 
      late stage NSCLC using the 5F or 6F regimes described, when planned to comparable 
      OAR BEDs as standard radical techniques. It appears toxicity from these regimes 
      should be within acceptable limits provided the dose-constraints described are 
      met. A Phase II study is required to fully assess safety and feasibility, the 
      outcomes of which could reduce the number of patient hospital visits for 
      radiotherapy, thereby benefiting patients and optimising resource utilisation.
CI  - Copyright (c) 2023 Associazione Italiana di Fisica Medica e Sanitaria. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Jones, Matthew
AU  - Jones M
AD  - Arden Cancer Centre, University Hospitals Coventry and Warwickshire, Coventry, 
      UK.
FAU - Rogers, Jane
AU  - Rogers J
AD  - Arden Cancer Centre, University Hospitals Coventry and Warwickshire, Coventry, 
      UK; Department of Physics, University of Warwick, Coventry CV4 7AL, UK.
FAU - Kumar Shrimali, Raj
AU  - Kumar Shrimali R
AD  - Arden Cancer Centre, University Hospitals Coventry and Warwickshire, Coventry, 
      UK. Electronic address: Raj.Shrimali@uhcw.nhs.uk.
FAU - Hamilton, Jo
AU  - Hamilton J
AD  - Arden Cancer Centre, University Hospitals Coventry and Warwickshire, Coventry, 
      UK.
FAU - Athmanathan, Senthil
AU  - Athmanathan S
AD  - Arden Cancer Centre, University Hospitals Coventry and Warwickshire, Coventry, 
      UK.
FAU - Jones, Bleddyn
AU  - Jones B
AD  - Gray Laboratory, CRUK/MRC Oxford Institute for Radiation Oncology, University of 
      Oxford, Oxford, UK.
LA  - eng
PT  - Journal Article
DEP - 20230331
PL  - Italy
TA  - Phys Med
JT  - Physica medica : PM : an international journal devoted to the applications of 
      physics to medicine and biology : official journal of the Italian Association of 
      Biomedical Physics (AIFB)
JID - 9302888
SB  - IM
MH  - Humans
MH  - Radiotherapy Dosage
MH  - Retrospective Studies
MH  - Feasibility Studies
MH  - *Radiotherapy, Intensity-Modulated/methods
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Carcinoma, Non-Small-Cell Lung/radiotherapy
MH  - Lung/pathology
MH  - *Lung Neoplasms/radiotherapy
MH  - Organs at Risk
OTO - NOTNLM
OT  - Hypofractionated
OT  - Lung radiotherapy
OT  - Palliative
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/04/03 06:00
MHDA- 2023/04/07 06:41
CRDT- 2023/04/02 18:05
PHST- 2022/07/22 00:00 [received]
PHST- 2023/02/02 00:00 [revised]
PHST- 2023/02/26 00:00 [accepted]
PHST- 2023/04/07 06:41 [medline]
PHST- 2023/04/03 06:00 [pubmed]
PHST- 2023/04/02 18:05 [entrez]
AID - S1120-1797(23)00036-4 [pii]
AID - 10.1016/j.ejmp.2023.102559 [doi]
PST - ppublish
SO  - Phys Med. 2023 Apr;108:102559. doi: 10.1016/j.ejmp.2023.102559. Epub 2023 Mar 31.