Iris Walraven1, Michel van den Heuvel2, Judi van Diessen1, Eva Schaake1, Wilma Uyterlinde2, Joachim Aerts3, Frederieke Koppe4, Henk Codrington5, Peter Kunst6, Edith Dieleman7, Paul van de Vaart8, Marcel Verheij1, Jose Belderbos9. 1. Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 2. Department of Thoracic Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 3. Department of Pulmonary Medicine, Amphia Hospital, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. 4. Department of Radiation Oncology, Verbeeten Institute, Tilburg, The Netherlands. 5. Department of Pulmonary Medicine, Haga Hospital, The Hague, The Netherlands. 6. Department of Pulmonary Medicine, Academic Medical Center, Amsterdam, The Netherlands. 7. Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands. 8. Department of Radiation Oncology, MC Haaglanden, The Hague, The Netherlands. 9. Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: j.belderbos@nki.nl.
Abstract
BACKGROUND AND PURPOSE: Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy. MATERIALS AND METHODS: A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated. RESULTS:Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS. DISCUSSION: In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.
RCT Entities:
BACKGROUND AND PURPOSE: Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy. MATERIALS AND METHODS: A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLCpatients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated. RESULTS: Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS. DISCUSSION: In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLCpatients.
Authors: Anna Merlotti; Alessio Bruni; Paolo Borghetti; Sara Ramella; Vieri Scotti; Marco Trovò; Rita Chiari; Frank Lohr; Umberto Ricardi; Emilio Bria; Giovanni L Pappagallo; Rolando M D'Angelillo; Stefano Arcangeli Journal: Radiol Med Date: 2021-05-05 Impact factor: 3.469
Authors: Noëlle van der Voort van Zyp; Masoma Hashimzadah; Erik Kouwenhoven; Carmen Liskamp; Christa Gadellaa-van Hooijdonk; Ellen Pouw; Jose Belderbos; Klaartje Maas; Paul van de Vaart; Mirjam Mast Journal: Clin Transl Radiat Oncol Date: 2022-07-07
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