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High-Dose Hyperfractionated Accelerated Radiotherapy in Non-Small Cell Lung Cancer


Dirk De Ruysscher, MD, PhD, Bart Reymen, MD, and Angela van Baardwijk, MD, PhD

NSCLC is one of the most frequent and lethal cancers worldwide [1], and local and distant tumor control rates for those with the disease remain disappointingly low. In a recent report, local failure rates after surgery were 16%, 23%, 37%, 39%, and 30% for patients with stage IA, IB, IIA, IIB, and IIIA disease, respectively [2]. Only a few patients in this series had stage III NSCLC, and even fewer had N2 disease. In a Phase II trial in selected patients with resectable N2 disease who could be operated on after induction cisplatin–docetaxel chemotherapy (75 of 90 patients), the cumulative incidence of local tumor failure was 60% after 5 years [3]. Thus, it is clear that after surgical treatment of patients with stage III NSCLC, local tumor failure rates are high, even after an R0 resection.

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