Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial

@article{Saunders1997ContinuousHA,
  title={Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial},
  author={Michele I. Saunders and Stanley Dische and A. J. Barrett and Angela Harvey and Della Gibson and MaheshK. B. Parmar},
  journal={The Lancet},
  year={1997},
  volume={350},
  pages={161-165}
}
BACKGROUND Human tumour cells can proliferate rapidly, and giving radiotherapy in many small fractions may reduce long-term normal-tissue morbidity. [...] Key Method We included patients with NSCLC localised to the chest with a performance status of 0 or 1 in whom radical radiotherapy was chosen as the definitive management. Patients were randomly allocated in a 3:2 ratio to CHART or conventional radiotherapy. The latter was thirty fractions of 2 Gy to a total dose of 60 Gy in 6 weeks. Expand
Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial. CHART Steering committee.
TLDR
This trial shows that control of local tumour can lead to an improvement in long term survival and demonstrates the importance of cellular repopulation as a cause of failure in the radiotherapy of NSCLC. Expand
Accelerated radical radiotherapy for non-small cell lung cancer using two common regimens: a single-centre retrospective study of outcome.
TLDR
The authors' hypofractionated outcome is similar to that previously reported, but despite this being the UK's most common regimen, 55 Gy in 20 daily fractions remains unvalidated by phase III trial data. Expand
Continuous Hyperfractionated Accelerated Radiotherapy (CHART) for Non-small Cell Lung Cancer (NSCLC): 7 Years' Experience From Nine UK Centres.
TLDR
It is confirmed that CHART remains deliverable with low toxicity rates and the dose-escalated CHART regimen forward in a randomised phase II study of sequential chemoradiotherapy against other accelerated dose- escalated schedules is taken. Expand
Very low acute toxicity of three fractions per day accelerated radiotherapy given after induction chemotherapy and surgery in stage III non-small cell lung cancer.
TLDR
The feasibility of this treatment according to Simon is assessed, choosing Grade 4 (G4) toxicity as main criteria, and it can be inferred that the toxicity of the treatment is acceptable, assuming as acceptable a non-toxic rate of 0.95 for a 90% power. Expand
Induction chemotherapy and continuous hyperfractionated accelerated radiotherapy (chart) for patients with locally advanced inoperable non-small-cell lung cancer: the MRC INCH randomized trial.
TLDR
Despite closing early because of poor accrual, and so failing to show clear evidence of a survival benefit for the additional chemotherapy, the results suggest that CHART, and ICT before CHart, remain important options for the treatment of inoperable NSCLC and deserve further study. Expand
Escalated dose for non-small-cell lung cancer with accelerated hypofractionated three-dimensional conformal radiation therapy.
TLDR
This study demonstrates the feasibility of the experimental radiotherapy schedule, however more data are needed to confirm its efficacy. Expand
73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer.
  • P. Maguire, L. Marks, +6 authors M. Anscher
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2001
TLDR
This regimen yielded favorable survival results, particularly for T1 lesions, and is currently using doses > or = 86 Gy, which seems greater than for conventional RT, though most patients recovered. Expand
Continuous hyperfractionated accelerated radiation therapy week-end less in combination with neoadjuvant chemotherapy for the treatment of stage III non-small-cell lung cancer.
TLDR
It is suggested that conformal three-dimensional hyperfractionated accelerated radiotherapy omitting elective node irradiation can be used in combination with neoadjuvant chemotherapy to treat patients with stage III lung cancer. Expand
Programming of radiotherapy in the treatment of non-small-cell lung cancer--a way to advance care.
TLDR
CHART (continuous hyperfractionated accelerated radiotherapy) is the most novel and accelerated schedule tested, and a randomised controlled trial showed a significant survival advantage from CHART compared with conventional radiotherapy. Expand
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References

SHOWING 1-10 OF 23 REFERENCES
Randomised multicentre trials of CHART vs conventional radiotherapy in head and neck and non-small-cell lung cancer: an interim report. CHART Steering Committee.
TLDR
The hypothesis that tumour cell repopulation can occur during a conventional course of radiotherapy and be a cause of treatment failure is supported. Expand
Continuous, hyperfractionated, accelerated radiotherapy (CHART) in non-small cell carcinoma of the bronchus.
TLDR
Between January 1985 and December 1988, 62 patients with locally advanced carcinoma of the bronchus were treated by radiotherapy using continuous, hyperfractionated, accelerated radiotherapy (CHART), and complete regression, as observed radiologically, was achieved. Expand
Costs of conventional radical radiotherapy versus continuous hyperfractionated accelerated radiotherapy (CHART) in the treatment of patients with head and neck cancer or carcinoma of the bronchus. Medical Research Council CHART Steering Committee.
  • D. Coyle, M. Drummond
  • Medicine
  • Clinical oncology (Royal College of Radiologists (Great Britain))
  • 1997
TLDR
Comparing the costs of treatment with continuous hyperfractionated accelerated radiotherapy (CHART) and those of conventional radiotherapy for patients with head and neck cancer and carcinoma of the bronchus will help facilitate a decision about whether the benefits of CHART are worth the additional costs of hospital-based resource use. Expand
Thoracic radiation therapy alone compared with combined chemoradiotherapy for locally unresectable non-small cell lung cancer. A randomized, phase III trial.
TLDR
Chemotherapy with MACC, in combination with thoracic radiotherapy, did not result in significant survival advantage compared with radiation alone (P greater than 0.2) in patients with medically inoperable or unresectable stage III non-small cell lung cancer. Expand
Is control of the primary tumour worthwhile in non-oat cell carcinoma of the bronchus?
  • M. Saunders
  • Medicine
  • Clinical oncology (Royal College of Radiologists (Great Britain))
  • 1991
TLDR
An increase in local tumour control and survival has been shown in a comparison with the results achieved in previous cases, and CHART and the combination of chemotherapy and radiotherapy are both the subject of multicentre randomized controlled trials in the United Kingdom. Expand
Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials
TLDR
The results of this meta-analysis suggest that chemotherapy may have a role in treating non-small cell lung cancer, and reached conventional levels of significance when used with radical radiotherapy and with supportive care. Expand
Radiation Therapy Oncology Group (RTOG) 88-08 and Eastern Cooperative Oncology Group (ECOG) 4588: preliminary results of a phase III trial in regionally advanced, unresectable non-small-cell lung cancer.
TLDR
In "good-risk" patients with surgically unresectable non-small-cell lung cancer, induction chemotherapy followed by irradiation was superior to hyperfractionated radiation therapy or standard radiation therapy alone, yielding a statistically significant short-term survival advantage. Expand
Long‐term observations of the patterns of failure in patients with unresectable non‐oat cell carcinoma of the lung treated with definitive radiotherapy report by the radiation therapy oncology group
TLDR
The high frequency of brain metastases suggests that, as in small cell carcinoma of the lung, elective irradiation of the brain may be necessary, if not to improve survival to enhance the quality of life of patients with adenocarcinoma and large cell carcinomas. Expand
Radiotherapy as an alternative to surgery in elderly patients with resectable lung cancer.
TLDR
It is concluded that in patients over 70 years of age with resectable lung cancer, radiotherapy with curative intent should be offered as an alternative to operation, especially if the tumor is not larger than 4 cm. Expand
Non-small-cell lung cancer: should unresectable stage III patients routinely receive high-dose radiation therapy?
  • D. Payne
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1988
TLDR
There is a need to further refine reproducible criteria, both anatomic and non-anatomic, to permit more appropriate selection of patients for high-dose treatment, and studies involving less rather than more treatment with appropriate endpoints might be both ethical and appropriate. Expand
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