Hypofractionated Radiotherapy for Limited Stage Small Cell Lung Cancer

The ideal chest radiotherapy dose/fractionation scheme for limited stage small cell lung cancer is undefined. Strategies of radiotherapy dose intensification with minimization of overall treatment time are felt to improve cure rates for LS-SCLC. Hypofractionation (giving higher than standard daily doses) facilitates both of these goals. In this study, we propose to use a dose escalated hypofractionated regimen of chest radiotherapy for patients with LS-SCLC.

Inclusion criteria

• limited stage small cell lung cancer
• adequate pulmonary function test (FEV1 >1.0 L, DLCO >50%)
• signed study consent
• age at least 18 years
• Karnofsky performance status as least 70%
• eligible to receive standard concurrent small cell cancer chemotherapy

Exclusion criteria

• extensive stage disease
• mixed non small cell and small cell histology
• inadequate pulmonary function tests
• not eligible for concurrent chemotherapy
• subtotal or total tumor resection
• previous chest/neck radiotherapy
• prior or concurrent malignancy except non-melanomatous skin unless disease free for last 5 years
• pregnant
• prior chemotherapy for another malignancy
• patients with myocardial infarction within the preceding 6 months of symptomatic heart disease, including, angina, congestive heart failure, uncontrolled arrhythmias