120P - Neoadjuvant chemotherapy followed by either continuous hyper-fractionated accelerated radiation therapy week-end less or conventional chemo-radioth...

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Anticancer Agents
Surgical Oncology
Non-Small Cell Lung Cancer
Biological Therapy
Radiation Oncology
Presenter RAJESH Sinwer
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors R.K. Sinwer1, H.S. Kumar2, M. Paramanandhan2, R. Purohit1, N. Sharma1, S.N. Sharma1
  • 1Radiation Oncology, Acharya Tulsi Regional Cancer Treatment & Research Institute, 334001 - Bikaner/IN
  • 2Radiotherapy, Acharya Tulsi Cancer Treatment & Research Institut, 334001 - Bikaner/IN



The unresectable stage III lung cancer is usually treated concurrently with radiotherapy & chemotherapy both. The locoregional control & increased overall survival obtained by CHART was more than the calculated by meta-analysis trials of chemo-radiotherapy. In an effort to dose escalation and to make CHART more feasible it was modified to a CHART weekend-less regimen, called CHARTWEL. In the recent past some trials have indicated therapeutic advantage with CHARTWEL combined with induction chemotherapy. In this present prospective single institute study we compared the results of induction CT followed by CHARTWEL vs chemo radiation in the form of conventional radiation therapy.


In 2014 total 60 consecutive patients with unresectable stage III NSCLC, ECOG 0–2, who met inclusion criteria were randomly assigned in two different arms of CCRT and CHARTWEL. Before radiotherapy all were given four cycles of NACT in form of paclitaxel & cisplatin three weekly. After three weeks of completion of the fourth cycle, radiotherapy was planned. In CHARTWEL arm 30 patients received two dimensional radiotherapy using three daily fractions 1.5 Gy in 5 days/week to a total dose of 58.5 Gy while in CCRT arm 30 received 66 Gy/33fr with conventional fractionation. Disease response was evaluated in form of OS and DFS at 12 months after treatment completion of the last enrolled patient.


At one year overall survival and median survival was 60% and 9.83 months [95% CI 8.80–10.85)] in CHARTWEL & 52% and 9.70 months [CI 95% (8.59–10.81)] in CCRT arm respectively. Median DFS was 6.8 months [95% CI 5.31–8.28)] and 5.0 months [CI 95% (3.67–6.32)] in CHARTWEL and CCCRT arm respectively. (p value >0.05). There was no statistical difference in grades of toxicities except persistent oesophagitis grade III seen in two patients of study arm (p value 


Study suggests that CHARTWEL can be used in combination with neoadjuvant chemotherapy to treat patients with locally advanced lung cancer. The advantage of CHARTWEL as smaller dose & shorter duration confounding accelerated repopulation comparative to conventional radiotherapy.

Clinical trial identification

Legal entity responsible for the study

Institutional Ethical Committee


Acharya Tulasi Regional Cancer Institute


All authors have declared no conflicts of interest.