Split-Course Chemoradiotherapy for Locally Advanced Non-small Cell Lung Cancer: A Single-Institution Experience of 144 Patients

Abstract

Split-course CRT appeared effective and was delivered with a favorable toxicity profile. Poor-risk patients experienced better than expected survival. Prospective evaluation of split-course CRT must be completed before it can be considered a standard treatment option in locally advanced NSCLC.

Efficacy and Tolerability of Palliative Split-Course Thoracic Chemoradiotherapy for Symptomatic Non–Small Cell Lung Cancer

“…9 Chemotherapy was generally delivered with a platinum doublet at systemically active doses. The most common regimens were carboplatin area under the curve 4 on day 1, with paclitaxel (100 mg/m 2 ) on days 1 and 8, etoposide (80 mg/m 2 ) on days 1 to 3, or pemetrexed (500 mg/m 2 ) on day 1.…”

“…At Rush University Medical Center (RUMC), patients with stage IIIA/B disease have been routinely managed with preoperative or definitive split-course concurrent chemoradiotherapy. 9,10 The excellent tolerance of this regimen, particularly with respect to esophagitis, has led to the adoption of this approach for palliative treatment in patients with intact PS. This paradigm allows for both thoracic symptom palliation and the immediate introduction of systemically active cytotoxic chemotherapy.…”

Feasibility of split-course stereotactic ablative radiotherapy for oligometastases

“…For patients with locally advanced head and neck cancers who were not candidates for standard continuous course RT because of a high risk of complications, split-course RT was applied and showed well-tolerated, safe treatment results with significant durable locoregional control ( 14 ). Gielda et al ( 16 ) reported their experience of split-course RT with chemotherapy in Stage III NSCLC patients with pre-treatment weight loss and a poor performance status. These patients completed the planned treatment and showed a favorable outcome with a median survival of 22 months.…”

Surgical Treatment Results of Patients with Locally Advanced (pT4) Non-Small Cell Lung Cancer

“…Работы, в которых показывается долгосрочная выжива-емость при химиолучевом лечении пациентов с местно-распространенным Т4 НМРЛ имеют существенный недостаток, заключающийся в некорректном стадировании. Так, в публикации результатов ретроспективного исследования, охватывающего опыт химиолучевого лечения 144 пациентов в период с 1999 по 2005 гг, со-общается о достижении медианы выживаемости 22,1 мес., трехлетней выживаемости 32,1% [15]. При включении пациентов в исследование от-сутствовало морфологическое подтверждение метастатического поражения медиастинальных лимфоузлов.…”

“…При включении пациентов в исследование от-сутствовало морфологическое подтверждение метастатического поражения медиастинальных лимфоузлов. Верификация распространения опухоли на структуры средостения с помощью инвазивных методов имела место лишь у 35 % пациентов [15]. По этой причине результаты подобных исследований нельзя считать до-стоверными.…”