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@ARTICLE{Btof:302862,
      author       = {R. Bütof and L. Koi and S. Löck$^*$ and S. Appold and S.
                      Drewes and D. Koschel and J. Kotzerke and U. Nestle and S.
                      Adebahr and D. Zips and F. Heinzelmann and T. Hehr and D.
                      Bucher and J. Heide and C. Belka and F. Manapov and E.
                      Wasilewska-Tesluk and J. Fleckenstein and M. Krause$^*$ and
                      E. Troost$^*$ and M. Baumann$^*$},
      title        = {{A}ccelerated vs. conventionally fractionated postoperative
                      radiotherapy of non-small cell lung cancer-final results of
                      the prematurely terminated {PORTAF} trial.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {nn},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2025-01402},
      pages        = {nn},
      year         = {2025},
      note         = {#LA:E220# / epub},
      abstract     = {A prolonged overall treatment time (OTT) has been
                      demonstrated to adversely affect the primary radiation
                      therapy (RT) outcome in various solid tumors, including
                      non-small cell lung cancer (NSCLC). Retrospective data from
                      our group suggested an advantage of shorter OTT also for
                      postoperative RT (PORT) in patients with NSCLC. The PORTAF
                      trial (ClinicalTrials.gov: NCT02189967) was initiated to
                      prospectively test this hypothesis.The multicenter
                      prospective randomized phase II trial in patients with NSCLC
                      investigated whether an accelerated schedule of PORT (7
                      fractions per week, 2 Gy per fraction, OTT 3.5-4 weeks)
                      improved outcome compared to conventional fractionation (5
                      fractions per week, 2 Gy per fraction, OTT 5-6 weeks).
                      Target volumes and total radiation doses were stratified in
                      both treatment arms based on individual risk factors.
                      Primary endpoint of the study was locoregional tumor control
                      (LRTC) 36 months after PORT, with 154 patients to be
                      included in each arm.Due to slow accrual and changed
                      indications for PORT, we prematurely closed the trial in
                      2019. Between 2014 and 2019, eight recruiting centers
                      included 27 evaluable patients. An interim safety analysis
                      performed for the first 21 patients showed nonsignificant
                      differences regarding grade 3 toxicities between the
                      treatment arms, thus not meeting the termination criteria.
                      LRTC was not significantly different between accelerated
                      $(73\%)$ and conventionally fractionated RT $(92\%;$ p =
                      0.535). Noteworthily, in 21 FDG-PET/CT restagings before RT,
                      an unexpectedly high number of locoregional recurrences (n =
                      4) and distant metastases (n = 2) were seen, resulting in
                      changed treatment intentions for these patients.The
                      prematurely closed PORTAF trial did not find significant
                      differences in 3‑year LRTC when comparing accelerated
                      versus conventionally fractionated irradiation. The observed
                      additional benefit of FDG-PET/CT restaging prior to PORT
                      should be further investigated in a larger cohort to
                      optimize patient selection and avoid unnecessary
                      side-effects.},
      keywords     = {Fractionation (Other) / Non-small-cell lung cancer (Other)
                      / Overall treatment time (Other) / Positron-emission
                      tomography (Other) / Postoperative radiotherapy (Other)},
      cin          = {DD01 / E220},
      ddc          = {610},
      cid          = {I:(DE-He78)DD01-20160331 / I:(DE-He78)E220-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40663146},
      doi          = {10.1007/s00066-025-02422-y},
      url          = {https://inrepo02.dkfz.de/record/302862},
}