Treatment-Related Pneumonitis and Acute Esophagitis in Non–Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Song, Choong Eui; Pyo, Hongryull; Moon, Sung Ho; Kim, Tae Hyun; Kim, Dae Woong; Cho, Kwan Ho

doi:10.1016/j.ijrobp.2009.08.068

Cited by 74 publications

(60 citation statements)

References 31 publications

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“…The incidences of acute RE ≥ grade 2 was significantly lower in the HT group than in the 3D-CRT group (P=0.027). Our results were in line with previous studies (26,27). Grade ≥2 esophagitis was seen in 40% of patients with NSCLC in a phase I dose escalation trial of proton beam therapy (27).…”

Section: Discussionsupporting

confidence: 92%

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Feasibility and efficacy of helical intensity-modulated radiotherapy for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT

Huang

Chen

et al. 2016

J. Thorac. Dis.

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Background:The standard treatment for stage III non-small-cell lung cancer (NSCLC) is still 60 Gy in conventional fractions combined with concurrent chemotherapy; however, the resulting local controls are disappointing. The aim of this study was to compare and assess the feasibility and efficacy of hypofractionated chemoradiotherapy using helical tomotherapy (HT) with conventional fractionation as opposed to using three-dimensional conformal radiotherapy (3D-CRT) for stage III NSCLC. Methods: Sixty-nine patients with stage III (AJCC 7th edition) NSCLC who underwent definitive radiation treatment at our institution between July 2011 and November 2013 were reviewed and analyzed retrospectively. A dose of 60 Gy in 20 fractions was delivered in the HT group (n=34), whereas 60 Gy in 30 fractions in the 3D-CRT group (n=35). Primary endpoints were toxicity, overall response rate, overall survival (OS) and progression-free survival (PFS). Results: The median follow-up period was 26.4 months. V20 (P=0.005), V30 (P=0.001), V40 (P=0.004), mean lung dose (P=0.000) and max dose of spinal cord (P=0.005) were significantly lower in the HT group than in the 3D-CRT group. There was no significant difference in the incidences of acute radiation pneumonitis (RP) ≥ grade 2 between the two groups, whereas the incidences of acute radiation esophagitis ≥ grade 2 were significantly lower in the HT group than in the 3D-CRT group (P=0.027). Two-year overall response rate was significantly higher in the HT group than in the 3D-CRT group (P=0.015). One-and 2-year OS rates were significantly higher in the HT group (95.0% and 68.7%, respectively) than in the 3D-CRT group (85.5% and 47.6%, respectively; P=0.0236). One-and 2-year PFS rates were significantly higher in the HT group (57.8% and 26.3%, respectively) than in the 3D-CRT group (32.7% and 11.4%, respectively; P=0.0351). Univariate analysis indicated that performance status (PS), T stage and radiotherapy technique were significant prognostic factors for both OS and PFS. Multivariate analysis indicated that PS and radiotherapy technique were independent prognostic factors of OS and PS was independent prognostic factor of PFS. Conclusions: Hypofractionated chemoradiotherapy via HT can shorten the radiotherapy time without increasing treatment-related toxicity. The preliminary findings are that OS and PFS can be improved by hypofractionated chemoradiotherapy via HT for patients with stage III NSCLC.

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Section: Discussionsupporting

confidence: 92%

“…A fatal esophagotracheal fistula was also seen in our study. Pre-radiation poor PS (≥ ECOG 2), TLV5, CLV5, and CLV10 were the main determinants of the risk of treatment-related death (26). Our study showed central NSCLC with N3 staging treated with 3D-CRT tended to have a higher incidence of esophagitis.…”

Section: Discussionmentioning

confidence: 57%

Feasibility and efficacy of helical intensity-modulated radiotherapy for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT

Huang

Chen

et al. 2016

J. Thorac. Dis.

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“…27,28 When analyzing the predictive factors potentially involved in the development of RP, we could find neither dosimetric nor clinical factors significantly associated with treatment-related toxicity. In contrast to some other series employing HT in either a conventional or a hypofractionated schedule for primary and metastatic lung tumours, where cutoff values for ipsilateral 29 and contralateral percentage of lung volume receiving 5 Gy 11,30 have been proposed, these findings confirm our previous experience with HHT on a limited cohort of patients with early-stage NSCLC. 31 Fourth, we provided a detailed radiological description of lung appearances after HHT and concluded that a specific pattern of lung injury was not associated with this technique.…”

Section: Discussionsupporting

confidence: 86%

Treatment outcomes and patterns of radiologic appearance after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) for lung tumours

Arcangeli

Falcinelli²,

Bracci

et al. 2017

The British Journal of Radiology

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Cite this article as: Arcangeli S, Falcinelli L, Bracci S, Greco A, Monaco A, Dognini J, et al. Treatment outcomes and patterns of radiologic appearance after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) for lung tumours. Objective: To evaluate treatment outcomes and patterns of CT lung injury after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) in a series of inoperable lung lesions. Methods: 68 patients who were medically inoperable (69 lesions) without evidence of viable extrathoracic disease were included. Dose prescription was driven by tumour location (hilar/pericentral vs peripheral) and/or target volume.

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“…In the treatment of lung cancer with IMRT, low dose irradiation to the lung has been reported to be a risk factor for radiation pneumonitis (3,4). To reduce the lung volume receiving low dose radiation, we reported the usefulness of tomotherapy using static ports (TomoDirect ® mode) for the treatment of locally advanced lung cancer (5).…”

Section: Technology In Cancer Research and Treatment 2014 June 16 Epubmentioning

confidence: 99%

“…The role of tomotherapy has now been established for the treatment of various targets (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). With the conventional…”

Section: Introductionmentioning

confidence: 99%

Helical and Static-Port Tomotherapy Using the Newly-Developed Dynamic Jaws Technology for Lung Cancer

Manabe¹,

Sugie²,

Hayashi³

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Treatment-Related Pneumonitis and Acute Esophagitis in Non–Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Cited by 74 publications

References 31 publications

Feasibility and efficacy of helical intensity-modulated radiotherapy for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT

Feasibility and efficacy of helical intensity-modulated radiotherapy for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT

Treatment outcomes and patterns of radiologic appearance after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) for lung tumours

Helical and Static-Port Tomotherapy Using the Newly-Developed Dynamic Jaws Technology for Lung Cancer

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