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Forschungsdatenbank PMU-SQQUID

Non-small cell lung cancer in stages I-IIIB: Long-term results of definitive radiotherapy with doses ≥ 80 Gy in standard fractionation.
Wurstbauer, K; Weise, H; Deutschmann, H; Kopp, P; Merz, F; Studnicka, M; Nairz, O; Sedlmayer, F;
STRAHLENTHER ONKOL. 2010; 186(10): 551-557.
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Deutschmann Heinz
Sedlmayer Felix
Studnicka Michael
Wurstbauer Karl

Abstract

Purpose: To investigate therapeutic outcome of dose escalation >= 80 Gy in nonresected non-small cell lung cancer (NSCLC). Patients and Methods: 124 consecutive patients with histologically/cytologically proven NSCLC were enrolled. Tumor stage I, II, IIIA, and MB was diagnosed in 30, eight, 39, and 47 patients, respectively. 38 patients (31%) had weight loss > 5% during the 3 months before diagnosis. A median dose of 88.2 Gy (range 80.0-96.0 Gy), 69.3 Gy (63.0-88.0 Gy) and 56.7 Gy was applied to primary lesions, involved lymph nodes, and elective nodes (within a region of about 6 cm cranial to macroscopically involved nodes), respectively. Daily fractional ICRU doses of 2.0-2.2 Gy were delivered by the conformal target-splitting technique. 58 patients (47%) received induction chemotherapy, in median two cycles prior to radiotherapy. Results: Median follow-up time of all patients was 19 months, of patients alive 72.4 months (69-121 months). The cumulative actual overall survival rate at 2 and 5 years amounts to 39% and 11.3%, respectively, resulting in a median overall survival time of 19.6 months. According to stages I, II, IIIA, and IIIB, the median overall survival times are 31.8, 31.4, 19.0, and 14.5 months, respectively. The locoregionat tumor control rate at 2 years is 49%. Apart from one treatment-related death (pneumonitis), acute toxicity according to EORTC/RTOG scores was moderate: lung grade 2 (n = 7), grade 3 (n = 3); esophagus grade 1 (n = 11); heart grade 3 (n = 1, pericarditis). No late toxicity grade > 1 has been observed. Conclusion: Sequential, conventionally fractionated high-dose radiotherapy by conformal target splitting is well tolerated. The results for survival and locoregional tumor control seem to at least equalize the outcome of simultaneous chemoradiation approaches, which, at present, are considered "state of the art" for patients with nonresected NSCLC. A higher potential of radiation therapy might be reached by accelerated fractionation regimens.


Useful keywords (using NLM MeSH Indexing)

Aged

Aged, 80 and over

Antineoplastic Agents/therapeutic use

Carcinoma, Non-Small-Cell Lung/drug therapy

Carcinoma, Non-Small-Cell Lung/pathology*

Carcinoma, Non-Small-Cell Lung/radiotherapy*

Combined Modality Therapy/methods

Dose Fractionation*

Female

Humans

Lung Neoplasms/drug therapy

Lung Neoplasms/pathology*

Lung Neoplasms/radiotherapy*

Male

Middle Aged

Neoplasm Staging

Radiotherapy/methods*

Radiotherapy Dosage

Radiotherapy Planning, Computer-Assisted/methods

Weight Loss


Find related publications in this database (Keywords)

Non-small cell lung cancer
Radiotherapy
Conformal radiotherapy
Target splitting
Dose escalation