Intensity-modulated radiation therapy (IMRT) for inoperable non-small cell lung cancer: The Memorial Sloan-Kettering Cancer Center (MSKCC) experience

Sura, S.; Gupta, Vishal; Yorke, Ellen; Jackson, Andrew; Amols, Howard; Rosenzweig, Kenneth E.

doi:10.1016/j.radonc.2008.02.005

Cited by 125 publications

(96 citation statements)

References 38 publications

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“…The most likely explanation for the favorable results in our study is the high number of patients with early stage cancer. While 51.9% of all patients had stage Ⅰ/Ⅱ NSCLC in our study, patients with stage Ⅰ/Ⅱ NSCLC represented 0-27% of all patients in previously published studies (Yom et al, 2007, Sura et al, 2008, Liao et al, 2010, Govaert et al, 2012, Jiang et al, 2012. To confirm the favorable results of our study, additional studies with larger sample sizes and longer follow-up durations will be required.…”

Section: Discussionsupporting

confidence: 61%

“…Our study also showed favorable locoregional recurrence-free survival rate compared with previous studies. The 2-year locoregional recurrence-free survival rate was 64.5% in our study compared to the 50-58% reported in previously published studies (Yom et al, 2007, Sura et al, 2008, Jiang et al, 2012. The most likely explanation for the favorable results in our study is the high number of patients with early stage cancer.…”

Section: Discussionsupporting

confidence: 47%

“…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%

“…Many planning studies demonstrated the theoretical dosimetric advantages of intensity-modulated RT over 3-dimensional conformal RT (Grills et al, 2003, Murshed et al, 2004, Wu et al, 2004, Chang et al, 2005, Schwarz et al, 2005, Christian et al, 2007. However, few published studies have reported the clinical outcome of intensitymodulated RT in NSCLC (Sura et al, 2008, Liao et al, 2010, Govaert et al, 2012, Jiang et al, 2012.…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

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“…[25][26][27] The use of CRT can be insufficient for large and/or centrally located lesions or for patients who have widespread lymph node involvement and can lead to increased toxicity rates and the inability to reach an appropriate dose. [28][29][30] Liu et al demonstrated that IMRT could reduce the irradiated volumes of normal lung tissue and other critical structures significantly while maintaining an adequate dose to the target volume. 31 When the complexity of target volumes increases, the difference between CRT and IMRT becomes even more significant in favor of IMRT.…”

Section: Discussionmentioning

confidence: 99%

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

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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.

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Effect of Second-generation vs Third-generation Chemotherapy Regimens With Thoracic Radiotherapy on Unresectable Stage III Non–Small-Cell Lung Cancer

et al. 2021

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Insufficient data are available regarding the long-term outcomes and cumulative incidences of toxic effects that are associated with chemoradiotherapy (CRT) for patients with stage III non-small-cell lung cancer.OBJECTIVE To evaluate survival and late toxic effects 10 years after patients were treated with curative CRT.DESIGN, SETTING, AND PARTICIPANTS This multicenter, phase 3 West Japan Thoracic Oncology Group (WJTOG) 0105 randomized clinical trial was conducted between September 2001 and September 2005 in Japan. Patients with histologically or cytologically confirmed non-small-cell lung cancer with unresectable stage III disease were assessed for eligibility.

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Intensity-modulated radiation therapy (IMRT) for inoperable non-small cell lung cancer: The Memorial Sloan-Kettering Cancer Center (MSKCC) experience

Cited by 125 publications

References 38 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

Effect of Second-generation vs Third-generation Chemotherapy Regimens With Thoracic Radiotherapy on Unresectable Stage III Non–Small-Cell Lung Cancer

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