Intensity-Modulated Radiation Therapy May Improve Local-Regional Tumor Control for Locally Advanced Non-Small Cell Lung Cancer Compared With Three-Dimensional Conformal Radiation Therapy

Wang, Jingbo; Zhou, Zongmei; Liang, Jun; Feng, Qinfu; Xiao, Zefen; Hui, Zhouguang; Wang, Xiaozhen; Lv, Jima; Chen, Dongfu; Zhang, Hongxing; Ji, Zhe; Cao, Jianzhong; Li-pin, Liu; Jiang, Wei; Men, Yu; Cai, Xu; Dai, Jiangrong; Yin, Wenwu; Wang, Lühua

doi:10.1634/theoncologist.2016-0155

Cited by 32 publications

(31 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Radiation technique development and better supportive care have brought opportunities of definitive treatment for selective patients with poor performance status. Compared with 3D-CRT, IMRT has been reported to reduce treatmentrelated toxicities including esophageal and pulmonary toxicity [23,24]. In addition, employing timely supportive care made acute toxicities manageable in order to avoid treatment interruptions and discontinuations.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

Bi¹,

Li-pin²,

Liang³

et al. 2020

BMC Cancer

Self Cite

View full text Add to dashboard Cite

Background: There is no consensus on the therapeutic approach to ECOG 2 patients with locally advanced non-smallcell lung cancer (LA-NSCLC), despite the sizable percentage of these patients in clinical practice. This study focused on the efficacy, toxicity and the optimal chemotherapy regimen of CCRT in ECOG 2 patients in a phase III trial. Methods: Patients capable of all self-care with bed rest for less than 50% of daytime were classified as ECOG 2 subgroup. A subgroup analysis was performed for ECOG 2 patients recruited in the phase III trial receiving concurrent EP (etoposide + cisplatin)/PC (paclitaxel + carboplatin) chemotherapy with intensity-modulated radiation therapy (IMRT) or three-dimensional conformal external beam radiation therapy (3D-CRT).Results: A total of 71 ECOG 2 patients were enrolled into the study. Forty-six (64.8%) patients were treated with IMRT technique. The median overall survival (OS) and progression free survival (PFS) for ECOG 2 patients were 16.4 months and 9 months, respectively. No difference was observed in treatment compliance and toxicities between ECOG 2 patients and ECOG 0-1 patients. Within the ECOG 2 group (31 in the EP arm and 40 in the PC arm), median OS and 3year OS were 15.7 months and 37.5% for the EP arm, and 16.8 months and 7.5% for the PC arm, respectively (p = 0.243). The incidence of grade ≥ 3 radiation pneumonitis was higher in the PC arm (17.5% vs. 0.0%, p = 0.014) with 5 radiation pneumonitis related deaths, while the incidence of grade 3 esophagitis was numerically higher in the EP arm (25.8% vs. 10.0%, p = 0.078). Conclusions: CCRT provided ECOG 2 patients promising outcome with acceptable toxicities. EP might be superior to PC in terms of safety profile in the setting of CCRT for ECOG 2 patients. Prospective randomized studies based on IMRT technique are warranted to validate our findings. Trial registration: ClinicalTrials.gov registration number: NCT01494558. (

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

Bi¹,

Li-pin²,

Liang³

et al. 2020

BMC Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…Physically, IMRT achieved improved dose distribution compared with 3DCRT. A higher dose led to greater side effects (especially cardiac and pulmonary), offsetting the survival advantage of incremental radiotherapy (21). Underestimation of the severe toxicity of high-dose radiotherapy may be the main reason behind the failed improvements of survival rates (21,22).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of CT‑guided 125I brachytherapy in elderly patients with non‑small cell lung cancer

et al. 2020

View full text Add to dashboard Cite

Non-small cell lung cancer (NSCLC) has become the most common cancer type and the leading cause of cancer-associated mortality worldwide. The aim of the present retrospective study was to evaluate the efficacy and safety of computed tomography (CT)-guided 125 I brachytherapy alone in elderly patients with NSCLC. A total of 26 elderly patients with NSCLC stage I-III who had an inoperable lesion or progressive disease following radio-chemotherapy were treated with CT-guided 125 I seed implantation for lung lesions and included in the present study. The prescribed dose of 125 I brachytherapy was 80-140 Gy, and dosimetric verification was performed immediately after the procedure. The response rate (RR) and local control rate (LCR) were analyzed according to the Response Evaluation Criteria in Solid Tumors (version 1.1). Survival was estimated using the Kaplan-Meier method. Safety and complications were also documented. All patients were aged 65-85 years (median age, 77 years) and successfully completed the procedure, and the median follow-up time was 9.4 months (range, 3-31 months). After a 6-month follow-up, for pulmonary lesions, complete response (CR) was achieved in 11 (42.3%) cases, partial response in 9 (34.6%) cases, stable disease in 4 (15.4%) cases and progressive disease in 2 (7.7%) cases. The 6-month RR and LCR were 76.9 (20/26) and 92.3% (24/26), respectively. The mean overall survival (OS) time was 11.7±7.6 months and the 0.5-and 1-year OS rates were 90.1 and 73.3%, respectively. Tumor-related symptoms in patients were significantly alleviated following the procedure. No severe complications occurred during and after the procedure of 125 I seed implantation. In conclusion, CT-guided 125 I brachytherapy is a feasible, effective and safe therapy and may be considered as an alternative option to surgery and radiotherapy for elderly patients with NSCLC.

show abstract

“…Based on asymptomatic oncogenesis and poor prognosis in NSCLC patients, external beam radiotherapy was conventional therapeutic approach to patients with metastatic or relapsed NSCLC. With the purpose of deliver more accurate treatment to tumors whilst sparing radiation dosage to normal tissues, advanced technology have been emerged in thoracic radiotherapy, but the 5-year rate was still under 20% in NSCLC [ 28 ]. The greatest potential to increase the effectiveness of radiotherapy lies in combining it with radiosensitizer, either by targeting tumor cells directly or by modifying the tumor microenviroment [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Selective ATP hydrolysis inhibition in F1Fo ATP synthase enhances radiosensitivity in non-small-cell lung cancer cells (A549)

et al. 2017

View full text Add to dashboard Cite

BackgroundF1Fo-ATP synthase (F1Fo-ATPase) is a reversibly rotary molecular machine whose dual functions of synthesizing or hydrolyzing ATP switch upon the condition of cell physiology. The robust ATP-hydrolyzing activity occurs in ischemia for maintaining the transmembrane proton motive force of mitochondria inner membrane, but the effect of F1Fo-ATPase on X-ray response of non-small-cell lung cancer (NSCLC) cells is unknown.Methods and FindingsWe studied whether ATP hydrolysis affected X-ray radiation induced cell death. NSCLC cells (A549) were pretreated with BTB06584 (BTB), an elective ATP hydrolysis inhibitor, followed by X-ray radiation. Cell viability and clonogenic survival were markedly decreased, clear indications of enhanced radiosensitivity through BTB incubation. Additionally, ATP5α1 was upregulated in parallel with elevated ATP hydrolytic activity after X-ray radiation, showing an increased mitochondrial membrane potential (ΔΨm). ATP hydrolysis inhibition led to collapse of ΔΨm suggesting ATP hydrolytic activity could enhance ΔΨm after X-ray radiation. Furthermore, we also demonstrated that apoptosis was pronounced with the prolonged collapse of ΔΨm due to hydrolysis inhibition by BTB incubation.ConclusionOverall, these findings supported that ATP hydrolysis inhibition could enhance the radiosensitivity in NSCLC cells (A549) after X-ray radiation, which was due to the collapse of ΔΨm.

show abstract

Intensity-Modulated Radiation Therapy May Improve Local-Regional Tumor Control for Locally Advanced Non-Small Cell Lung Cancer Compared With Three-Dimensional Conformal Radiation Therapy

Cited by 32 publications

References 20 publications

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

Efficacy and safety of CT‑guided 125I brachytherapy in elderly patients with non‑small cell lung cancer

Selective ATP hydrolysis inhibition in F1Fo ATP synthase enhances radiosensitivity in non-small-cell lung cancer cells (A549)

Contact Info

Product

Resources

About