Results of high-dose thoracic irradiation incorporating beam's eye view display in non-small cell lung cancer: A retrospective multivariate analysis

Hazuka, Mark B.; Turrisi, Andrew T.; Lutz, S; Martel, Mary K.; Haken, Randall K. Ten; Strawderman, Myla; Borema, P.Lynn; Lichter, S. Robert

doi:10.1016/0360-3016(93)90238-q

Cited by 87 publications

(19 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is substantial evidence that local control probabilities have been improved as the prescribed dose of XRT increases (Hayman et al 2001). However, in the treatment of lung cancer, the risk of developing radiation pneumonitis (RP) has limited any attempts for dose escalation that might improve local control probabilities (Hazuka et al 1993).…”

Section: Treatment Proceduresmentioning

confidence: 99%

Dosimetric Factors Used for Thoracic X-Ray Radiotherapy are not Predictive of the Occurrence of Radiation Pneumonitis after Carbon-Ion Radiotherapy

Koto

Tsujii²,

Yamamoto³

et al. 2007

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Radiation pneumonitis (RP) is one of the most common dose-limiting toxicities in thoracic X-ray radiotherapy (XRT). Dosimetric factors are used for prediction of the occurrence of RP after XRT. Carbon-ion radiotherapy (CRT) is a promising modality because of its excellent dose localization and high biological effect on tumors. This study aims to analyze the relationship between dosimetric factors developed for XRT and the incidence of RP in patients with stage I non-small cell lung cancer (NSCLC) after CRT. We examined 80 inoperable patients with NSCLC. The ranges of the daily fraction sizes and the total doses were from 3.3 to 8.8 GyE and from 59.4 to 95.4 GyE, respectively. These doses were successfully delivered with acceptable toxicity; grade 2 RP was observed in 8 patients (10%). The severity of RP was graded within 6 months of the initiation of CRT using the Radiation Therapy Oncology Group criteria. These results indicate the excellent dose distribution of CRT. We then compared the dosimetric data of the 8 patients developed grade 2 RP with those of 72 patients developed grade 1 RP. Dosimetric factors useful for predicting RP in XRT, such as the percentage of the computed tomography-defined total lung volume receiving > 5, > 20, and > 30 GyE, and mean lung dose, were not predictive factors for RP after CRT. The dosimetric factors used for XRT are not applicable for CRT in patients with NSCLC. The dosimetric factors for CRT remain to be developed.non-small cell lung cancer; carbon-ion radiotherapy; radiation pneumonitis; dosimetric factor; normal tissue

show abstract

Section: Treatment Proceduresmentioning

confidence: 99%

Dosimetric Factors Used for Thoracic X-Ray Radiotherapy are not Predictive of the Occurrence of Radiation Pneumonitis after Carbon-Ion Radiotherapy

Koto

Tsujii²,

Yamamoto³

et al. 2007

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

show abstract

“…Attempts at dose escalation of TRT have been limited because of toxicity issues when higher doses are used. Using conformal planning techniques, it is possible to increase the radiation dose administered, perhaps by improving tumor targeting and limiting excessive dose to normal tissue [5]. Other strategies with fractionated accelerated schedules may also lead to improved local efficacy of TRT.…”

Section: Introductionmentioning

confidence: 99%

“…Several trials comparing platinum-based induction regimens followed by TRT, compared to TRT alone in unresectable stage IIIA/B disease, have reported longer median and long-term survival among patients receiving the induction chemotherapy [3, [12][13][14]. Unfortunately both local and distant control remains suboptimal, and novel approaches addressing strategies designed to improve both local and distant control are needed [3,5,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Carboplatin/Paclitaxel or Carboplatin/Vinorelbine Followed by Accelerated Hyperfractionated Conformal Radiation Therapy: A Preliminary Report of a Phase I Dose Escalation Trial from the Carolina Conformal Therapy Consortium

Socinski

2001

The Oncologist

View full text Add to dashboard Cite

The maximum tolerated dose of conformal radiation therapy delivered at 1.6 Gy bid is being assessed in patients with unresectable stage IIB-IIIB non-small cell lung cancer who have been treated with induction regimens consisting of carboplatin plus paclitaxel or carboplatin plus vinorelbine. Data from the early stages of this parallel phase I study show that the two induction regimens are similar in toxicity and that both induce partial responses in 45% of patients. Both regimens can be followed by conformal radiotherapy using an accelerated hyperfractionated schedule to a dose of at least 80 Gy without experiencing unacceptable toxicity. Key morbidity observed thus far has involved the esophagus. Further cohorts of patients will receive higher doses of conformal radiotherapy (in 6.4 Gy increments) until the maximum tolerated dose is reached. The Oncologist 2001;6(suppl 1):20-24

show abstract

“…We would like to point out that in connection with 3-DTP and dose escalation the target volume concept in radiotherapy of non-small cell lung cancer is again under discussion. There seems to be a trend that in conformal radiation of lung cancer the volume of irradiated lymphatics should be reduced [2,51]. Target delineation in the CT scans remains a challenging problem in CRT of lung cancer.…”

Section: Lung Cancermentioning

confidence: 99%

“…However, at present it is unclear whether dose escalation will improve the therapeutic ratio in terms of increased tumor control and survival rate while maintaining a low incidence of acute side effects and long-lasting normal tissue complications. Only a few pilot studies [3,6,49,51,58] were performed as mentioned above. Prior to starting such dose escalation studies it is essential to precisely describe and define the target volume.…”

Section: Conclusion and Future Prospectsmentioning

confidence: 99%

Three-Dimensional Radiation Treatment Planning: Principles and Practice

Zimmermann¹,

Molls²

1998

Oncol Res Treat

View full text Add to dashboard Cite

The clinical outcome in radiooncological treatment of malignant tumors such as glioblastomas and non-small-cell lung cancer is disappointing. In order to obtain a better local tumor control and survival rates, dose escalation seems to be an appropriate way. Especially in those anatomical sites where radiosensitive tissues surround the tumor a further increase of the total radiation dose with conventional radiotherapy is critical. In numerous studies 3-D treatment planning and its clinical realization as conformal radiotherapy demonstrated an improvement in dose distribution for the target volume as well as the surrounding radiosensitive tissues compared with 2-D conventional treatment planning. The high-dose region was very well conformed to the tumor. Outside the tumor the radiation dose decreased steeply. For prostate cancer it has been shown that an increase of the total dose is tolerable. The number of normal tissue complications remained low. We ex-pect that 3-D treatment planning and conformal radiotherapy may substantially improve the therapeutic ratio. There is no doubt that oncology in general, and especially radiooncology, may profit from this new technology in the near future. Continued clinical research, however, is necessary to take full advantage of this promising method.

show abstract

Results of high-dose thoracic irradiation incorporating beam's eye view display in non-small cell lung cancer: A retrospective multivariate analysis

Cited by 87 publications

References 30 publications

Dosimetric Factors Used for Thoracic X-Ray Radiotherapy are not Predictive of the Occurrence of Radiation Pneumonitis after Carbon-Ion Radiotherapy

Dosimetric Factors Used for Thoracic X-Ray Radiotherapy are not Predictive of the Occurrence of Radiation Pneumonitis after Carbon-Ion Radiotherapy

Carboplatin/Paclitaxel or Carboplatin/Vinorelbine Followed by Accelerated Hyperfractionated Conformal Radiation Therapy: A Preliminary Report of a Phase I Dose Escalation Trial from the Carolina Conformal Therapy Consortium

Three-Dimensional Radiation Treatment Planning: Principles and Practice

Contact Info

Product

Resources

About