Jeremic B, Shibamoto Y
Department of Oncology, University Hospital, Kragujevac, Yugoslavia.
Int J Radiat Oncol Biol Phys. 1996 Jan 15;34(2):303-8. doi: 10.1016/0360-3016(95)02158-2.
To explore the influence of interfraction interval in hyperfractionated radiotherapy (HFX RT) with or without concurrent chemotherapy for Stage III nonsmall cell lung cancer.
One hundred sixty-nine patients treated in a randomized study were retrospectively analyzed. Group I patients were treated by HFX RT with 1.2 Gy twice daily with a total dose of 64.8 Gy in 27 treatment days, while Groups II and III patients were treated by the same HFX RT and concurrent chemotherapy with carboplatin and etoposide (every week in Group II and every other week in Group III). Interfraction intervals of either 4.5-5 h or 5.5-6 h were used for each patient.
Patients treated with shorter interfraction intervals (4.5-5 h) had a better prognosis than those treated with longer intervals (5.5-6 h) (median survival: 22 vs. 7 months; 5-year survival rate: 27% vs. 0%, p = 0.00000). This phenomenon was observed in all treatment groups. Patients > or = 60 years of age, with Stage IIIA disease, or with previous weight loss < or = 5% were treated more often with the shorter intervals than those < 60 years, with Stage IIIB disease, or with weight loss > 5%, respectively, but in all of these subgroups of patients, the shorter intervals were associated with a better prognosis. Multivariate analysis showed that the interfraction interval was an independent prognostic factor, together with sex, age, performance status, and stage. The shorter intervals were associated with an increased incidence of acute high grade toxicity, but not with an increase in late toxicity.
Patients treated with shorter interfraction intervals (4.5-5 h) appeared to have a better survival than those treated with longer intervals (5.5-6 h). Prospective randomized studies are warranted to further investigate the influence of interfraction interval in HFX RT.
探讨超分割放疗（HFX RT）中分次照射间隔时间对Ⅲ期非小细胞肺癌患者（无论是否联合化疗）的影响。
对一项随机研究中治疗的169例患者进行回顾性分析。I组患者接受超分割放疗，每日两次，每次1.2 Gy，27个治疗日的总剂量为64.8 Gy，而II组和III组患者接受相同的超分割放疗并联合卡铂和依托泊苷化疗（II组每周一次，III组每两周一次）。每位患者采用4.5 - 5小时或5.5 - 6小时的分次照射间隔时间。
采用较短分次照射间隔时间（4.5 - 5小时）治疗的患者比采用较长间隔时间（5.5 - 6小时）治疗的患者预后更好（中位生存期：22个月对7个月；5年生存率：27%对0%，p = 0.00000）。在所有治疗组中均观察到这种现象。年龄≥60岁、患有IIIA期疾病或既往体重减轻≤5%的患者，分别比年龄<60岁、患有IIIB期疾病或体重减轻>5%的患者更常采用较短的间隔时间，但在所有这些患者亚组中，较短的间隔时间均与较好的预后相关。多因素分析表明，分次照射间隔时间是一个独立的预后因素，与性别、年龄、体能状态和分期共同作用。较短的间隔时间与急性重度毒性发生率增加相关，但与晚期毒性增加无关。
采用较短分次照射间隔时间（4.5 - 5小时）治疗的患者似乎比采用较长间隔时间（5.5 - 6小时）治疗的患者生存更好。有必要进行前瞻性随机研究，以进一步探究分次照射间隔时间在超分割放疗中的影响。
