Is moderately hypofractionated RT using 60 Gy/20fx with concurrent chemotherapy appropriate for unresectable stage III NSCLC?

No perfect answers, as usual. We (CALGB) did a prospective multi-institutional Phase I trial asking the question, what is the MTD for hypofx treatment with concurrent chemo for stage 3 disease? We came to an MTD of 60 Gy in 24 fx (2.5 gy/fx). Urbanic et al., PMID 29487024. Inclusion was your typical...

This data shows fascinating outcomes, but I am not surprised at the "ho hum" reaction from most radiation oncologists. The reasons for this:

1. American radiation oncologists are loathe to trust data from other countries, China, in particular. As an example, there is a PMRT study for triple-negative ea...

Hi everyone. LTL FTP and sorry for the lengthy post.

I concur with Dr. @Dr. First Last and the Alliance Group that 60 Gy/24 fractions with chemo is acceptable. I would avoid 60 Gy/20 fractions outside of a clinical trial.

A long time ago (? galaxy far away), I opened an investigator-initiated trial ...

We have used this approach, but in a personalized way, accelerating the fractionation according to the ability to meet or beat conventional normal tissue dose constraints.

Our experience is summarized here: Hui et al., PMID 38065707.

This was mostly in the era before adjuvant immune checkpoint inhibi...

I trust readers of this thread appreciate that it is too simplistic to think through this conundrum with conversations limited to daily dose/fxn so they can just "go for it". Radiation therapy entails a 3-dimensional prescription that should always consider the volume of normal tissues that can get ...