188P - Palliative hypofractionated radiotherapy in south Egyptian patients with stage III and IV non-small cell lung cancer

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Surgical Oncology
Non-Small Cell Lung Cancer
Radiation Oncology
Presenter Marwa Khalaf
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors M. Khalaf1, A.M. Attia2
  • 1Clinical Oncology, Assiut University Hospitals, 002088 - Assiut/EG
  • 2Radiation Oncology, South Egypt Cancer Institute SECI Assiut University, 002088 - Assiut/EG



In patients with advanced non-small cell lung cancer the priority should be given to controlling symptoms of the disease and thoracic radiotherapy remains an important treatment modality for these patients. No consensus on which fractionation scheme should be used.The aim of the study is to evaluate the effect of hypofractionated regimen (36 Gy/12 fractions versus 17 Gy/2 weekly fractions regimen) on symptoms relief, assessment of treatment related toxicity and its impact on overall survival (OS) in patients


Patients were randomly assigned into two treatment groups: 1, receive 36 Gy per 12 fractions and group 2, receive 17 Gy per two fractions. Assessments by clinician for improvement of symptoms and toxicity were done weekly during radiotherapy, one month, 3 months and every 3 months thereafter. Symptomatic response was assessed by comparing the initial score for each symptom with the best score during follow-up period. A total symptom score (TSS) was produced for each patient, by adding the scores for each individual symptom.


The total symptom scores before radiotherapy was significantly higher to that after radiotherapy (Wilcoxon signed-rank test Z = −6.434, P = 0.0001). The degree and duration of symptom relief were equivalent in the treatment groups. There were no reported cases of grade 3 or 4 esophagitis or pulmonary toxicity. Grade 2 acute esophagitis was greater among patients received 36 Gy/ 12 fractions compared to those received 17 Gy/ 2 fractions (26.3% vs 14%, P = 0.177) but did not reach statistical significance. Two patients (3.5%) experienced grade 2 acute pneumonitis. No significant difference in survival among treatment groups was found (i year OS for group 1 was 22.3% and for group 2 was 20.4%, P = 0.434).


17 Gy/2 weekly fractions regimen, provide good symptomatic relief with comparable survival to 36 Gy/12 fractions regimen and should be used for patients requesting a shorter treatment course especially in which palliative chemotherapy is planned.

Clinical trial identification


Legal entity responsible for the study

Assiut University


Assiut University and South Cancer Inistitute


All authors have declared no conflicts of interest.