Matthew D Johnson1, Karna Sura1, Victor S Mangona1, Alexander Glick2, Michelle Wallace1, Hong Ye1, Inga S Grills3. 1. Department of Radiation Oncology, Beaumont Health System, Royal Oak, MI. 2. Department of Medical Oncology, Beaumont Health System, Royal Oak, MI. 3. Department of Radiation Oncology, Beaumont Health System, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Rochester, MI. Electronic address: Inga.grills@beaumont.edu.
Abstract
BACKGROUND: Recent data have called into question the use of dose-escalated radiotherapy for locally advanced non-small-cell lung cancer and the effect of cardiac radiotherapy doses. We compared the outcomes after chemoradiation using standard-dose (SD; ≤ 64 Gy) or high-dose (HD; > 64 Gy) radiotherapy. PATIENTS AND METHODS: A matched-pair analysis was performed of 178 patients with stage IIB-IIIB non-small-cell lung cancer for SD versus HD groups using age ± 5 years, gender, stage, tumor size ± 2 cm, yielding 86 patients. The clinical endpoints were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox regression method. RESULTS: The median follow-up was 16.8 months for the entire cohort (HD, 21.6 months; SD, 12.1 months; P = .06). No significant differences were found in disease stage, histologic type, age, performance status, gender, or tumor size between the 2 groups. The median overall survival was 23.1 months for the HD group (95% confidence interval, 20.6-25.5) versus 13.6 months for the SD group (95% confidence interval, 9.6-17.5; P = .03). The 2-year freedom from locoregional recurrence was 48.7% for the SD and 65.3% for the HD groups (P = .07). The 2-year freedom from distant metastasis was 46.7% for the SD and 70.3% for the HD groups (P = .05). A higher cardiac V30 dose (P = .03) was the strongest predictor of survival besides clinical stage (P = .02). CONCLUSION: Dose-escalated radiotherapy resulted in improved survival and recurrence rates. A higher cardiac dose was a significant predictor of decreased survival.
BACKGROUND: Recent data have called into question the use of dose-escalated radiotherapy for locally advanced non-small-cell lung cancer and the effect of cardiac radiotherapy doses. We compared the outcomes after chemoradiation using standard-dose (SD; ≤ 64 Gy) or high-dose (HD; > 64 Gy) radiotherapy. PATIENTS AND METHODS: A matched-pair analysis was performed of 178 patients with stage IIB-IIIB non-small-cell lung cancer for SD versus HD groups using age ± 5 years, gender, stage, tumor size ± 2 cm, yielding 86 patients. The clinical endpoints were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox regression method. RESULTS: The median follow-up was 16.8 months for the entire cohort (HD, 21.6 months; SD, 12.1 months; P = .06). No significant differences were found in disease stage, histologic type, age, performance status, gender, or tumor size between the 2 groups. The median overall survival was 23.1 months for the HD group (95% confidence interval, 20.6-25.5) versus 13.6 months for the SD group (95% confidence interval, 9.6-17.5; P = .03). The 2-year freedom from locoregional recurrence was 48.7% for the SD and 65.3% for the HD groups (P = .07). The 2-year freedom from distant metastasis was 46.7% for the SD and 70.3% for the HD groups (P = .05). A higher cardiac V30 dose (P = .03) was the strongest predictor of survival besides clinical stage (P = .02). CONCLUSION: Dose-escalated radiotherapy resulted in improved survival and recurrence rates. A higher cardiac dose was a significant predictor of decreased survival.
Authors: Eunsin Lee; Jing Zeng; Robert S Miyaoka; Jatinder Saini; Paul E Kinahan; George A Sandison; Tony Wong; Hubert J Vesselle; Ramesh Rengan; Stephen R Bowen Journal: Med Phys Date: 2017-06-01 Impact factor: 4.071
Authors: Romana Wass; Maximilian Hochmair; Bernhard Kaiser; Brane Grambozov; Petra Feurstein; Gertraud Weiß; Raphaela Moosbrugger; Felix Sedlmayer; Bernd Lamprecht; Michael Studnicka; Franz Zehentmayr Journal: Cancers (Basel) Date: 2022-06-30 Impact factor: 6.575