A Comparison of Radiation Techniques in Patients Treated With Concurrent Chemoradiation for Stage III Non-Small Cell Lung Cancer

Peng, Jiming; Pond, Greg; Donovan, Elysia; Ellis, Peter; Swaminath, Anand

doi:10.1016/j.ijrobp.2019.12.027

Cited by 26 publications

(12 citation statements)

References 27 publications

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“…Although there is no direct comparison of 3D-CRT and IMRT for LA-NSCLC, many retrospective studies have shown the efficacy and safety of IMRT for LA-NSCLC [ 11–13 ]. Based on these back grounds, IMRT for LA-NSCLC is increasingly performed [ 14 ]. Another change in radiotherapy treatment for LA-NSCLC is the use of involved field radiotherapy (IFRT) instead of elective nodal irradiation (ENI).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of intensity modulated radiotherapy with involved field radiotherapy for Japanese patients with locally advanced non-small cell lung cancer

Abe

Iino

Saitô

et al. 2021

Journal of Radiation Research

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The feasibility of intensity modulated radiotherapy (IMRT) with involved field radiotherapy (IFRT) for Japanese patients with locally advanced non-small cell lung cancer (LA-NSCLC) remains unclear. Here we reviewed our initial experience of IMRT with IFRT for Japanese patients with LA-NSCLC to evaluate the feasibility of the treatment. Twenty LA-NSCLC patients who were treated with IMRT with IFRT during November 2019 to October 2020 were retrospectively analyzed. All patients received 60 Gy in 30 fractions of IMRT and were administered concurrent platinum-based chemotherapy. The median patient age was 71 years old and the group included 15 men and 5 women. The patient group included 2 patients with stage IIB, 11 patients with stage IIIA, 5 patients with stage IIIB, and 2 patients with stage IIIC disease. Histological diagnosis was squamous cell carcinoma in 14 patients, adenocarcinoma in 5 patients, and non-small cell lung cancer in 1 patient. The median follow-up period was 8 months. The incidence of grade 3 or greater pneumonitis was 5%, and grade 3 or greater esophagitis was not observed. None of the patients developed regional lymph node, with only recurrence reported so far. These findings indicate that IMRT with IFRT for Japanese patients with LA-NSCLC is feasible in terms of acute toxicity. Further study with a larger number of patients and longer follow-up to clarify the effect of treatment on patient prognosis is required.

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Section: Introductionmentioning

confidence: 99%

Feasibility of intensity modulated radiotherapy with involved field radiotherapy for Japanese patients with locally advanced non-small cell lung cancer

Abe

Iino

Saitô

et al. 2021

Journal of Radiation Research

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“…For lung cancer, intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc radiotherapy (VMAT) techniques have a significant dosimetric advantage over 3D conformal radiation therapy. [1][2][3][4][5] Several studies have focused on dosimetric differences between IMRT and VMAT plans for lung cancer. [6][7][8] Li et al 9 discovered specific advantages of various IMRT and VMAT strategies for lung cancer in different locations and proposed the application of different planning techniques for lung cancer treatment according to the classification-central or peripheral-and the requirements of the organs at risk (OARs).…”

Section: Introductionmentioning

confidence: 99%

“…For lung cancer, intensity‐modulated radiotherapy (IMRT) and volumetric‐modulated arc radiotherapy (VMAT) techniques have a significant dosimetric advantage over 3D conformal radiation therapy. 1 , 2 , 3 , 4 , 5 Several studies have focused on dosimetric differences between IMRT and VMAT plans for lung cancer. 6 , 7 , 8 Li et al.…”

Section: Introductionmentioning

confidence: 99%

Comparison of combinations of irradiation techniques and jaw conditions in intensity‐modulated radiotherapy for lung cancer

Peng

Shi

Zhang

et al. 2021

J Applied Clin Med Phys

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Purpose: To assist in the selection of a suitable combination of an irradiation technique and jaw condition in intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc radiotherapy (VMAT) for lung cancer treatment plans. Materials and methods: Thirty patients with lung cancer who underwent radiotherapy were enrolled retrospectively. They were categorized as having central lung cancer, peripheral lung cancer with mediastinal lymph node metastasis (peripheral E lung cancer), and peripheral lung cancer without mediastinal lymph node metastasis (peripheral N lung cancer). Four treatment plans were designed for each patient: fixed jaw and adaptive jaw IMRT technique (FJ-IMRT and JA-IMRT), and fixed jaw and jaw tracking VMAT technique (FJ-VMAT and JT-VMAT). The dose parameters of the four group plans were compared and analyzed. Results: Compared to FJ-IMRT, JA-IMRT significantly reduced the mean dose (D mean ) and volume percentage of 5 Gy (V 5Gy ) of the total lung in central and peripheral N lung cancer. Similarly, compared to FJ-VMAT, JT-VMAT provided better protection to most organs at risk (OARs), particularly for total lung and heart. In comparison with IMRT, VMAT significantly improved the conformity index (CI) of the planning target volume for the three lung cancer classifications, and it reduced the dose of almost all OARs except V 5Gy and D mean of the total lung. Moreover, the mean monitor units of the VMAT groups were far lower than the IMRT groups. Conclusion: Based on the dosimetric findings and considering clinical data published on lung and heart side effects, we propose recommendations on the preferred treatment technique based on tumor location and pulmonary function. For central lung cancer with normal pulmonary function, we advise JT-VMAT techniques. Conversely, for central lung cancer with poor pulmonary function, we recommend JA-IMRT techniques. We advocate JA-IMRT for peripheral E lung cancer. For peripheral N lung cancer, JT-VMAT techniques are strongly recommended.

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“…Radiation therapy serves as an important modality for the treatment of NSCLC. Despite major advances in the field of radiotherapy technology during the past decades ( 3 , 4 ), the prognosis for 5-year survival rate in patients with inoperable locally advanced NSCLC is still poor (approximately 12–24%) ( 5 ) due to radioresistance related local recurrence ( 6 ). Increasing radiation dose is an important strategy for overcoming radiation tolerance; however, the risk of normal tissue toxicity always limits the dose escalation ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Capilliposide C from Lysimachia capillipes Restores Radiosensitivity in Ionizing Radiation-Resistant Lung Cancer Cells Through Regulation of ERRFI1/EGFR/STAT3 Signaling Pathway

Chen

Feng

et al. 2021

Front. Oncol.

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AimsRadiation therapy is used as the primary treatment for lung cancer. Unfortunately, radiation resistance remains to be the major clinic problem for lung cancer patients. Lysimachia capillipes capilliposide C (LC-C), an extract from LC Hemsl, has demonstrated multiple anti-cancer effects in several types of cancer. Here, we investigated the potential therapeutic impacts of LC-C on radiosensitivity in lung cancer cells and their underlying mechanisms.MethodsNon-small cell lung cancer cell lines were initially irradiated to generate ionizing radiation (IR)-resistant lung cancer cell lines. RNA-seq analysis was used to examine the whole-transcriptome alteration in IR-resistant lung cancer cells treated with or without LC-C, and the differentially expressed genes with most significance were verified by RT-qPCR. Colony formation assays were performed to determine the effect of LC-C and the target gene ErbB receptor feedback inhibitor 1 (ERRFI1) on radiosensitivity of IR-resistant lung cancer cells. In addition, effects of ERRFI1 on cell cycle distribution, DNA damage repair activity were assessed by flow cytometry and γ-H2AX immunofluorescence staining respectively. Western blotting was performed to identify the activation of related signaling pathways. Tumor xenograft experiments were conducted to observe the effect of LC-C and ERRFI1 on radiosensitivity of IR-resistant lung cancer cells in vivo.ResultsCompared with parental cells, IR-resistant lung cancer cells were more resistant to radiation. LC-C significantly enhanced the effect of radiation in IR-resistant lung cancer cells both in vitro and in vivo and validated ERRFI1 as a candidate downstream gene by RNA-seq. Forced expression of ERRFI1 alone could significantly increase the radiosensitivity of IR-resistant lung cancer cells, while silencing of ERRFI1 attenuated the radiosensitizing function of LC-C. Accordingly, LC-C and ERRFI1 effectively inhibited IR-induced DNA damage repair, and ERRFI1 significantly induced G2/M checkpoint arrest. Additional investigations revealed that down-regulation of EGFR/STAT3 pathway played an important role in radiosensitization between ERRFI1 and LC-C. Furthermore, the high expression level of ERRFI1 was associated with high overall survival rates in lung cancer patients.ConclusionsTreatment of LC-C may serve as a promising therapeutic strategy to overcome the radiation resistance and ERRFI1 may be a potential therapeutic target in NSCLC.

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A Comparison of Radiation Techniques in Patients Treated With Concurrent Chemoradiation for Stage III Non-Small Cell Lung Cancer

Cited by 26 publications

References 27 publications

Feasibility of intensity modulated radiotherapy with involved field radiotherapy for Japanese patients with locally advanced non-small cell lung cancer

Feasibility of intensity modulated radiotherapy with involved field radiotherapy for Japanese patients with locally advanced non-small cell lung cancer

Comparison of combinations of irradiation techniques and jaw conditions in intensity‐modulated radiotherapy for lung cancer

Capilliposide C from Lysimachia capillipes Restores Radiosensitivity in Ionizing Radiation-Resistant Lung Cancer Cells Through Regulation of ERRFI1/EGFR/STAT3 Signaling Pathway

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