A palliative accelerated irradiation regimen (PAIR) for advanced non-small-cell lung cancer (NSCLC)

In order to avoid overtreatment in advanced NSCLC we developed a palliative accelerated irradiation regimen (PAIR) applying a total dose of 32 Gy in 10 days with two daily fractions of 2 Gy. This paper reports on a 1-year pilot study carried out in preparation of a randomised trial. Data for the 34...

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Main Authors: Nestle, Ursula (Author) , Nieder, Carsten (Author) , Abel, Ulrich (Author) , Niewald, Marcus (Author) , Ukena, Dieter (Author) , Berberich, Werner (Author) , Schnabel, Klaus (Author)
Format: Article (Journal)
Language:English
Published: 1996
In: Radiotherapy and oncology
Year: 1996, Volume: 38, Issue: 3, Pages: 195-203
ISSN:1879-0887
DOI:10.1016/0167-8140(96)01706-9
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/0167-8140(96)01706-9
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/0167814096017069
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Author Notes:Ursula Nestle, Carsten Nieder, Ulrich Abel, Marcus Niewald, Dieter Ukena, Werner Berberich, Klaus Schnabel

MARC

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520 |a In order to avoid overtreatment in advanced NSCLC we developed a palliative accelerated irradiation regimen (PAIR) applying a total dose of 32 Gy in 10 days with two daily fractions of 2 Gy. This paper reports on a 1-year pilot study carried out in preparation of a randomised trial. Data for the 34 patients receiving PAIR were compared to 179 conventionally irradiated historical controls selected from a pre-existing database according to identical inclusion criteria. Statistical analysis showed that PAIR patients had a significantly longer survival than controls (P = 0.0029). Median survival was 11.8 and 5.8 months, respectively, while 1-year survival was 45.6% vs. 21.2%. Compared to the subgroup of controls who had received the full planned dose of 60 Gy (n = 104) PAIR patients showed no significant difference in survival. In order to adjust for possible imbalances we used a comprehensive blinded prognostic rating design creating one score value per patient out of several known prognostic factors. After adjustment for the resulting prognostic score by means of the Cox proportional hazards model PAIR patients still showed significantly longer survival. We conclude that in advanced NSCLC survival after a palliative short-term regimen appears to be at least equivalent to that following conventional high-dose irradiation. 
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