Initial Evaluation of Treatment-Related Pneumonitis in Advanced-Stage Non–Small-Cell Lung Cancer Patients Treated With Concurrent Chemotherapy and Intensity-Modulated Radiotherapy

Yom, Sue S.; Liao, Zhongxing; Liu, H. Helen; Tucker, Susan L.; Hu, Chao; Xiong, Wei; Wang, Xuanming; Wang, Shulian; Mohan, Radhe; Cox, James D.; Komaki, Ritsuko

doi:10.1016/j.ijrobp.2006.12.031

Cited by 263 publications

(191 citation statements)

References 43 publications

Supporting

Mentioning

160

Contrasting

Unclassified

Order By: Relevance

“…Some studies have reported treatment outcomes of linac-based intensity-modulated RT in inoperable NSCLC, and the reported median overall survival time ranged 16.8-29.7 months, and the reported 1-and 2-year overall survival rates ranged 57-71% and 46-58%, respectively (Yom et al, 2007, Sura et al, 2008, Liao et al, 2010, Govaert et al, 2012, Jiang et al, 2012. In our study, the median overall survival time was 28.9 months, and 1-and 2-year overall survival rates were 96.2% and 92.0%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Helical Tomotherapy for Inoperable Non-Small Cell Lung Cancer: The Kyung Hee University Medical Center Experience

Kong¹,

Hong²

2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: Published studies on clinical outcome of helical tomotherapy for lung cancer are limited. The purpose of this study was to evaluate clinical outcomes and treatment-related toxicity in inoperable non-small cell lung cancer (NSCLC) patients treated with helical tomotherapy in Korea. Materials and Methods: Twentyseven patients with NSCLC were included in this retrospective study. Radiotherapy was performed using helical tomotherapy with a daily dose of 2.1-3 Gy delivered at 5 fractions per week resulting in a total dose of 62.5-69.3 Gy. We assessed radiation-related lung and esophageal toxicity, and analyzed overall survival, locoregional recurrence-free survival, distant metastasis-free survival, and prognostic factors for overall survival. Results: The median follow-up period was 28.9 months (range, 10.1-69.4). The median overall survival time was 28.9 months, and 1-, 2-, and 3-year overall survival rates were 96.2%, 92.0%, and 60.0%. The median locoregional recurrence-free survival time was 24.3 months, and 1-, 2-, and 3-year locoregional recurrence-free survival rates were 85.2%, 64.5%, and 50.3%. The median distant metastasis-free survival time was 26.7 months, and 1-, 2-, and 3-year distant metastasis-free survival rates were 92.3%, 83.9%, and 65.3%, respectively. Gross tumor volume was the most significant prognostic factor for overall survival. No grade 4 or more toxicity was observed. Conclusions: Helical tomotherapy in patients with inoperable NSCLC resulted in high survival rates with an acceptable level of toxicity, suggesting it is an effective treatment option in patients with medically inoperable NSCLC.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Helical Tomotherapy for Inoperable Non-Small Cell Lung Cancer: The Kyung Hee University Medical Center Experience

Kong¹,

Hong²

2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…Therefore, the current results are in line with previous retrospective reports on staticbeam IMRT in chemoradiation and dose-escalated conformal chemoradiation. 32,33 Compared with static IMRT, plan optimization possibilities with HT are more flexible and slightly better because of its rotational nature, resulting in the kind of dose delivery illustrated in Figure 2. 11 The dose to the nearby spinal cord could be limited to 50 Gy while expelling the 20-Gy isodose from the contralateral lung and maintaining the adequate coverage (>95% of prescribed dose) of the target.…”

Section: Discussionmentioning

confidence: 99%

“…The relative lung volumes that received 5 Gy and 10 Gy (V 5 /V 10 ) in the current series (Table 6) were comparable to the values reported in a clinical study using static-beam IMRT. 32 Preliminary correlation analyses of dose volumetric parameters and the occurrence of overall and RTOG grade !3 late lung toxicity were performed. Even in this small series, those analyses revealed the larger impact of highdose regions and primarily the tumor volume compared with low-dose spread (Table 6).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Toxicity report of a phase 1/2 dose‐escalation study in patients with inoperable, locally advanced nonsmall cell lung cancer with helical tomotherapy and concurrent chemotherapy

Bral

Duchateau

Versmessen

et al. 2009

Cancer

View full text Add to dashboard Cite

BACKGROUND:The objective of the current study was to evaluate the feasibility and toxicity of radiation dose escalation with concurrent chemotherapy using helical tomotherapy (HT) in patients with inoperable, locally advanced, stage III nonsmall cell lung cancer (LANSCLC) (grading determined according to the American Joint Committee on Cancer 6th edition grading system).METHODS:This phase 1/2 study was designed to determine the maximum tolerated dose (MTD) of radiotherapy in patients with LANSCLC administered concurrently with docetaxel and cisplatin. Radiotherapy was delivered using HT. A dose per fraction escalation was applied starting at 2 grays (Gy), with an increase of 6% per dose cohort (DC). The Radiation Therapy Oncology Group acute radiation morbidity score was used to monitor pulmonary, esophageal, and cardiac toxicity.RESULTS:Dose escalation was performed in 34 patients over 5 DCs to a dose per fraction of 2.48 Gy. No differences were observed in acute toxicity between the different DCs. However, a significant increase in late lung toxicity in DC IV, which received a fraction size of 2.36 Gy, necessitated a halt in further dose escalation with the MTD defined as 2.24 Gy per fraction. The overall incidence of acute grade ≥3 esophageal and pulmonary toxicity was 24% and 3%, respectively (grading determined according to the Radiation Therapy Oncology Group‐European Organisation for Research and Treatment of Cancer toxicity scoring system). The overall incidence of late lung toxicity was 21%, but the incidence was an acceptable 13% in DCs I, II, and III. The local response rate was 61% on computed tomography images.CONCLUSIONS:The use of HT to 67.2 Gy with concurrent cisplatin/docetaxel was feasible and resulted in acceptable toxicity. A full phase 2 study has been initiated to establish the true local response rate at the MTD of 2.24 Gy per fraction. Cancer 2010. © 2010 American Cancer Society.

show abstract

“…Thus, volumetric parameters such as V20 (percentage of pulmonary volume receiving ≥ 20 Gy), V10 and V5, and pulmonary mean dose have been shown to be the most important predictive factors for severe pulmonary toxicity. 14,[16][17][18] The lung is the thoracic organ most sensitive to the deleterious effects of radiation, but this does not mean that it is the only limiting anatomical structure to restrict the appropriate dose release. Spinal cord, esophagus, and heart are also restrictive.…”

Section: (B)mentioning

confidence: 99%

Guidelines for the treatment of lung cancer using radiotherapy

Chen

Novaes

Gadia

et al. 2017

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

Initial Evaluation of Treatment-Related Pneumonitis in Advanced-Stage Non–Small-Cell Lung Cancer Patients Treated With Concurrent Chemotherapy and Intensity-Modulated Radiotherapy

Cited by 263 publications

References 43 publications

Clinical Outcome of Helical Tomotherapy for Inoperable Non-Small Cell Lung Cancer: The Kyung Hee University Medical Center Experience

Clinical Outcome of Helical Tomotherapy for Inoperable Non-Small Cell Lung Cancer: The Kyung Hee University Medical Center Experience

Toxicity report of a phase 1/2 dose‐escalation study in patients with inoperable, locally advanced nonsmall cell lung cancer with helical tomotherapy and concurrent chemotherapy

Guidelines for the treatment of lung cancer using radiotherapy

Contact Info

Product

Resources

About