JBUON 2020; 25(2): 842-847 ISSN: 1107-0625, online ISSN: 2241-6293 • www.jbuon.com Email: editorial_ofce@jbuon.com ORIGINAL ARTICLE Corresponding author: Vassilis Kouloulias, MSc, MD, PhD. National and Kapodistrian University of Athens, Medical School, 2 nd Dept of Radiology, Radiotherapy Unit, Attikon University Hospital, Rimini 1, 12462, Chaidari, Greece. Tel: +30 210 5831880, Fax: +30 210 5326418, Email: vkouloul@med.uoa.gr Received: 17/08/2019; Accepted: 24/09/2019 A randomized study comparing two hypofractioned 3-D conformal radiotherapy for stage IIIb-IV non small cell lung cancer Anna Zygogianni 1 , Kalliopi Platoni 2 , Eyridiki Patriki 2 , Styliani Nikoloudi 1 , Andromachi Kougioumtzopoulou 2 , Eyfrosini Kypraiou 2 , Amanda Psyrri 3 , Nikolaos Trogkanis 2 , Efstathios Efstathopoulos 2 , John Georgakopoulos 2 , Pantelis Karaiskos 4 , Aikaterini Malagari 2 , Maria- Aggeliki Kalogeridi 2 , Nikolaos Kelekis 2 , Vassilis Kouloulias 2 1 National and Kapodistrian University of Athens, Medical School, 1 st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Athens, Greece; 2 National and Kapodistrian University of Athens, Medical School, 2 nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, Athens, Greece; 3 National and Kapodistrian University of Athens, Medical School, Oncology Unit, Attikon University Hospital, Athens, Greece; 4 National and Kapodistrian University of Athens, Medical Physics laboratory, Medical School, Athens, Greece. Summary Purpose: We compared the safety and efcacy of two hy- pofractionated irradiation schedules for elderly and low performance status patients with inoperable symptomatic non-small cell lung cancer (NSCLC). Methods: Patients that entered the study were either unft or without response concerning chemotherapy. We randomized 14 patients (group A) vs 15 patients (group B) who under- went two diferent hypofractionated radiotherapy schedules. Group Α patients underwent a scheme of 13x3 Gy, while group B patients received 2x8.5 Gy and one fraction of 6 Gy one week apart. Efcacy was assessed in terms of disease-free survival (DFS), tumor response and overall survival (OS). Toxicity according to RTOG/EORTC criteria and duration of symptoms were also evaluated. Results: Median follow up was 3 years. Median age was 64.5 years (group A) and 73 years (group B). Mean values for symptom palliation were higher for group B vs group A (3.20±1.21 vs 2.21±0.97, p=0.037), respectively. EORTC/ RTOG toxicity was signifcantly higher (p=0.046) for group A (1.57±0.51) vs group B (1.13±0.35). Duration of toxicity was signifcantly lower in group B compared to group A (p=0.001). Median OS was similar between groups, while DFS was better in group B than group A (p=0.023). Conclusions: Although safe conclusions are difcult to be ascertained, hypofractionated schedule B might be an alter- native scheme in elderly and low performance status patients ofering adequate palliation, good tumor control and accept- able toxicity. Key words: non small lung cancer, radiotherapy, hypofrac- tionated, toxicity, randomized study Introduction Many randomized trials [1-9] have been pub- lished on the alternative clinical role of hypofrac- tionated radiotherapy, confrming to be at least as safe and efective. In patients with locally advanced inoperable stage of non small cell lung cancer (NSCLC), hypofractionation ofers acceptable pal- liation compared to conventional schedules and without severe toxicity, probably due to lower bio- logic total dose [5-16]. In a previous study, we have reported our experience with weekly schedule of This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.