Hypofractionated radiation for lung cancer can be utilized for patients with ultracentral tumors or select patients who aren’t candidates for concurrent chemoradiation. This retrospective study took a look at 107 patients treated with either 60 Gy in 15 fractions (51.4%) or 72 Gy in 18 fractions (48.6%) to evaluate dosimetric predictors of lung toxicity. Most (62%) were selected for hypofractionated RT because they had central/ultracentral or nodal disease that wasn’t eligible for SBRT. Overall, 16.8% developed grade 2+ pneumonitis with no difference in the rate of pneumonitis between dose regimens. The authors identified the following thresholds with a 20% risk of pneumonitis: V20 17.7%, mean lung dose 10.6 Gy, and V5 41.3%. | Sasse, Pract Radiat Oncol 2023
