Association of different fractionation schedules for prophylactic cranial irradiation with toxicity and brain metastases-free survival in stage III non-small cell lung cancer: A pooled analysis of individual patient data from three randomized trials

Willem J A Witlox; Bram L T Ramaekers; Benjamin Lacas; Cecile Le Pechoux; Alexander Sun; Si-Yu Wang; Chen Hu; Mary Redman; Vincent van der Noort; Ning Li; Matthias Guckenberger; Harm van Tinteren; Harry J M Groen; Manuela A Joore; Dirk K M De Ruysscher

doi:10.1016/j.radonc.2021.09.029

Association of different fractionation schedules for prophylactic cranial irradiation with toxicity and brain metastases-free survival in stage III non-small cell lung cancer: A pooled analysis of individual patient data from three randomized trials

Radiother Oncol. 2021 Nov:164:163-166. doi: 10.1016/j.radonc.2021.09.029. Epub 2021 Oct 4.

Authors

Affiliations

¹ Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC), The Netherlands; Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Centre (MUMC), The Netherlands. Electronic address: [email protected].
² Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC), The Netherlands.
³ Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France.
⁴ Department of Radiation Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France.
⁵ Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto, Canada.
⁶ Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
⁷ NRG Oncology Statistics and Data Management Center, Philadelphia, United States; Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, United States.
⁸ Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, United States.
⁹ Department of Biometrics, Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands.
¹⁰ Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China.
¹¹ Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
¹² Trial and Data Center, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
¹³ Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, The Netherlands.
¹⁴ Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC), The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands.
¹⁵ Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Centre (MUMC), The Netherlands.

PMID: 34619235
DOI: 10.1016/j.radonc.2021.09.029

Abstract

We assessed the impact of different PCI fractionation schedules (30 Gy in 10 versus 15 fractions) on brain metastases-free survival (BMFS) and toxicity in stage III NSCLC. Our results suggest that 30 Gy in 10 fractions is associated with increased toxicity, while no conclusive evidence of improving BMFS was seen with this schedule.

Keywords: Brain metastases-free survival; Non-small cell lung cancer; Prophylactic cranial irradiation; Toxicity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Neoplasms* / radiotherapy
Carcinoma, Non-Small-Cell Lung* / radiotherapy
Cranial Irradiation / adverse effects
Humans
Lung Neoplasms* / radiotherapy
Percutaneous Coronary Intervention*
Randomized Controlled Trials as Topic