For late-stage NSCLC, it is potentially feasible and safe to administer high-dose palliative radiotherapy
using 5F or 6F regimes, versus com- parable organs at risk biological equivalent doses (BEDs), according
to a study published in Physica Medica. Raj Kumar Shrimali, MD, and colleagues sought to evaluate
the feasibility of shortened hypofractionated high-dose palliative lung radiotherapy. A total of
15 patients with late-stage (stage 3 or 4) NSCLC previously treated with the standard palliative 36
Gy in 12 fractions (12F) schedule were nonrandomly selected for a retrospective planning study.
The endpoint was to achieve a representative distribution of tumor volumes, sizes, and location.
Potential safety was assessed by using these BEDs and with reductions of 10% (BED-10%) and 20%
(BED-20%) to account for a reduction in tolerance doses from the effects of surgery or
chemotherapy. In all 15 5F and 6F plans, mandatory BED constraints were reached. In all 6F plans
and in six 5F plans, BED- 10% constraints were met and BED-20% constraints were reached by six 6F
and three 5F plans, respectively.