comparing the effectiveness and safety profiles of accelerated fractionation radiotherapy with concomitant boost and conventional fractionation radiotherapy for the treatment of inoperable locally advanced non-small cell lung cancer

Background and aim: non-small cell lung cancer (nsclc) has aggressive tumor growth and requires high radiation doses for effective tumor control. the purpose of this study was to compare the therapeutic efficacy and toxicity profiles of accelerated fractionation radiotherapy with a concurrent boost to standard radiotherapy protocols in patients with inoperable locally advanced non-small cell lung cancer (la-nsclc).material and methods: this randomized controlled trial was conducted in the radiation oncology department, rims, among 118 patients of la-nsclc distributed in two study arms during the period november 2020 to october 2022.  in arms a (n=59), patients received conventional radiotherapy consisting of 60 gy delivered in 30 fractions over six weeks. this regimen comprised 25 initial fractions of 2 gy each, followed by a 5-fraction boost. arm b (n=59) employed an accelerated fractionation schedule. patients initially received 19 fractions of 2 gy each. subsequently, they underwent twice-daily irradiation: 2 gy to the primary target volume in the morning, followed by a 1.5 gy boost to a reduced field in the evening, with a minimum 6-hour interval resulting in a total dose of 59 gy over 25 fractions in five weeks.results: patient demographics were well-matched. the response rate for arm-a was 54.2%, and in arm-b, it was 72.9% (p=0.035). arm-b demonstrated a longer median progression-free survival of 11 months compared to arm-a’s 9 months. the cumulative radiation-induced toxicities between the two groups did not show any statistically significant differences.conclusions: accelerated fractionated radiotherapy has significant potential as a treatment option for patients with inoperable nsclc.