A Fondevilla Soler1, J L López-Guerra2, M Dzugashvili1, P Sempere Rincón1, A Sautbaet3, P Castañeda4, J M Díaz4, J M Praena-Fernandez5, E Rivin Del Campo6, I Azinovic7. 1. Department of Radiation Oncology, Imoncology, Murcia, Spain. 2. Department of Radiation Oncology, University Hospital Virgen del Rocio, Manuel Siurot avenue, s/n, 41013, Seville, Spain. chanodetriana@yahoo.es. 3. Máster Internacional en Aplicaciones Tecnológicas Avanzadas en Oncología Radioterápica, Universidad de Murcia, Imoncology Fundación, Madrid, Spain. 4. Radiation Physics, Imoncology, Murcia, Spain. 5. Methodology Unit, University Hospital Virgen del Rocio, Seville, Spain. 6. Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, Paris, France. 7. Department of Radiation Oncology, Imoncology, Madrid, Spain.
Abstract
PURPOSE: The aim of this study was to assess the feasibility and treatment outcome of intensity modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) in locally advanced non-small cell lung cancer (NSCLC) patients. MATERIALS AND METHODS: A total of 64 NSCLC patients with stage IIB (3%), IIIA (36%), and IIIB (61%) were treated with concomitant (N = 47; 73%) or sequential (N = 9; 14%) chemotherapy between February 2009 and January 2014. Eight patients (13%) received RT alone. All patients received the same irradiation scheme using IMRT: prophylactic dose for mediastinum was 56 Gy at 1.65 Gy/fraction and SIB to macroscopic disease up to 68 Gy at 2 Gy/fraction. RESULTS: The median follow-up was 16 months (range, 1-70 months). The overall survival rate for all patients was 79% after 1 year and 46% after 2 years. Disease-free survival (DFS) was 81 and 45% after 1 and 2 years, respectively, resulting in a median DFS of 16 months. Multivariate analysis showed a statistically significant association between stage IIIB patients and a higher risk of mortality (HR 2.11; P = 0.019). In addition, T4 stage associated with higher risk of recurrence (HR 2.23; P = 0.024) while concomitant chemoradiation was associated with lower risk of any recurrence (HR 0.34; P = 0.004) No patient experienced grade ≥3 esophagitis and only 6 cases (9%) had grade 3 pneumonitis. Only having a higher lung volume was associated with higher risk of pneumonitis in the multivariate analysis (HR 16.21; P = 0.022). CONCLUSION: This study in advanced NSCLC patients shows that SIB-IMRT is an effective technique with acceptable toxicity, also when combined with chemotherapy.
PURPOSE: The aim of this study was to assess the feasibility and treatment outcome of intensity modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) in locally advanced non-small cell lung cancer (NSCLC) patients. MATERIALS AND METHODS: A total of 64 NSCLCpatients with stage IIB (3%), IIIA (36%), and IIIB (61%) were treated with concomitant (N = 47; 73%) or sequential (N = 9; 14%) chemotherapy between February 2009 and January 2014. Eight patients (13%) received RT alone. All patients received the same irradiation scheme using IMRT: prophylactic dose for mediastinum was 56 Gy at 1.65 Gy/fraction and SIB to macroscopic disease up to 68 Gy at 2 Gy/fraction. RESULTS: The median follow-up was 16 months (range, 1-70 months). The overall survival rate for all patients was 79% after 1 year and 46% after 2 years. Disease-free survival (DFS) was 81 and 45% after 1 and 2 years, respectively, resulting in a median DFS of 16 months. Multivariate analysis showed a statistically significant association between stage IIIB patients and a higher risk of mortality (HR 2.11; P = 0.019). In addition, T4 stage associated with higher risk of recurrence (HR 2.23; P = 0.024) while concomitant chemoradiation was associated with lower risk of any recurrence (HR 0.34; P = 0.004) No patient experienced grade ≥3 esophagitis and only 6 cases (9%) had grade 3 pneumonitis. Only having a higher lung volume was associated with higher risk of pneumonitis in the multivariate analysis (HR 16.21; P = 0.022). CONCLUSION: This study in advanced NSCLCpatients shows that SIB-IMRT is an effective technique with acceptable toxicity, also when combined with chemotherapy.
Authors: A R Vieira; L Abar; S Vingeliene; D S M Chan; D Aune; D Navarro-Rosenblatt; C Stevens; D Greenwood; T Norat Journal: Ann Oncol Date: 2015-09-14 Impact factor: 32.976
Authors: Alexandra D Jensen; Marc W Münter; Helge G Bischoff; Renate Haselmann; Uwe Haberkorn; Peter E Huber; Michael Thomas; Jürgen Debus; Klaus K Herfarth Journal: Cancer Date: 2011-01-24 Impact factor: 6.860
Authors: Asad A Shah; Mark F Berry; Ching Tzao; Mihir Gandhi; Mathias Worni; Ricardo Pietrobon; Thomas A D'Amico Journal: Ann Thorac Surg Date: 2012-06 Impact factor: 4.330
Authors: Cameron W Swanick; Steven H Lin; Jordan Sutton; Nilan S Naik; Pamela K Allen; Lawrence B Levy; Zhongxing Liao; James W Welsh; Ritsuko Komaki; Joe Y Chang; Daniel R Gomez Journal: Clin Lung Cancer Date: 2014-10-25 Impact factor: 4.785
Authors: Zhongxing X Liao; Ritsuko R Komaki; Howard D Thames; Helen H Liu; Susan L Tucker; Radhe Mohan; Mary K Martel; Xiong Wei; Kunyu Yang; Edward S Kim; George Blumenschein; Waun Ki Hong; James D Cox Journal: Int J Radiat Oncol Biol Phys Date: 2009-06-08 Impact factor: 7.038
Authors: O Raaschou-Nielsen; R Beelen; M Wang; G Hoek; Z J Andersen; B Hoffmann; M Stafoggia; E Samoli; G Weinmayr; K Dimakopoulou; M Nieuwenhuijsen; W W Xun; P Fischer; K T Eriksen; M Sørensen; A Tjønneland; F Ricceri; K de Hoogh; T Key; M Eeftens; P H Peeters; H B Bueno-de-Mesquita; K Meliefste; B Oftedal; P E Schwarze; P Nafstad; C Galassi; E Migliore; A Ranzi; G Cesaroni; C Badaloni; F Forastiere; J Penell; U De Faire; M Korek; N Pedersen; C-G Östenson; G Pershagen; L Fratiglioni; H Concin; G Nagel; A Jaensch; A Ineichen; A Naccarati; M Katsoulis; A Trichpoulou; M Keuken; A Jedynska; I M Kooter; J Kukkonen; B Brunekreef; R S Sokhi; K Katsouyanni; P Vineis Journal: Environ Int Date: 2015-11-28 Impact factor: 9.621
Authors: Nithya Ramnath; Thomas J Dilling; Loren J Harris; Anthony W Kim; Gaetane C Michaud; Alex A Balekian; Rebecca Diekemper; Frank C Detterbeck; Douglas A Arenberg Journal: Chest Date: 2013-05 Impact factor: 9.410
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396
Authors: Jing You; Dan Yang; Dongming Li; Leilei Jiang; Rong Yu; Huiming Yu; Bo Xu; Weihu Wang; Anhui Shi Journal: Zhongguo Fei Ai Za Zhi Date: 2019-11-20