Retrospective clinical study of simultaneous reduced dose in clinical target volume of radical intensity-modulated radiotherapy for treatment of stage Ⅲ non-small-cell lung cancer
Department of Radiation Oncology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China
Abstract：Objective To evaluate the efficacy and adverse effects of radical intensity-modulated radiotherapy (IMRT) with simultaneous reduced dose in clinical target volume (CTV) for inoperable stage Ⅲ non-small cell lung cancer (NSCLC). Methods A retrospective analysis was performed on a total of 70 patients with stage Ⅲ NSCLC who were admitted to our hospital from 2010 to 2014. All patients received simultaneous reduced-dose IMRT with a prescribed dose of 60 Gy in 30 fractions or 60.2 Gy in 28 fractions for primary gross tumor volume (PGTV, expansion of gross tumor volume by 0.5 cm) and a prescribed dose of 54 Gy in 30 fractions or 50.4 Gy in 28 fractions for planning target volume (PTV). In the 70 patients, 40 received neoadjuvant chemotherapy prior to radiotherapy, 50 concurrent chemoradiotherapy, and 25 adjuvant chemotherapy after radiotherapy. Short-term treatment outcomes and adverse reactions were evaluated. The Kaplan-Meier method was used for survival analysis. Results The median follow-up time was 42.8 months (16.9-68.3 months). The short-term response rate (complete response (CR) plus partial response (PR)) was 81.4%. The CR, PR, stable disease, and progressive disease rates were 7%(5/70), 74%(52/70), 13%(9/70), and 6%(4/70), respectively. In all patients, the median survival time was 26.6 months (5.2-68.3 months). The 2-year overall survival, local recurrence-free survival, and progression-free survival rates were 55%, 68%, and 45%, respectively. In all patients, 9%(6/70) had grade ≥3 radiation pneumonitis, 4%(3/70) grade ≥3 oesophagitis, and 7%(5/70) grade ≥3 myelosuppression. Conclusions IMRT with simultaneous reduced dose in CTV is effective for stage Ⅲ NSCLC. It deserves further prospective studies with large sample sizes.
Chen Xiuli,Liu Ningbo,Ji Kai et al. Retrospective clinical study of simultaneous reduced dose in clinical target volume of radical intensity-modulated radiotherapy for treatment of stage Ⅲ non-small-cell lung cancer [J]. Chinese Journal of Radiation Oncology, 2016, 25(7): 686-689.
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