Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy
| Autor: | Ritsuko Komaki, Sue S. Yom, Susan L. Tucker, Xuanming Wang, Zhongxing Liao, Radhe Mohan, H. Helen Liu, Chaosu Hu, Xiong Wei, James D. Cox, Shulian Wang |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Cancer Research Lung Neoplasms medicine.medical_treatment Disease-Free Survival law.invention Randomized controlled trial law Carcinoma Non-Small-Cell Lung medicine Carcinoma Confidence Intervals Humans Radiology Nuclear Medicine and imaging Lung cancer Pneumonitis Aged Retrospective Studies Aged 80 and over Chemotherapy Radiation business.industry Retrospective cohort study Radiotherapy Dosage Middle Aged medicine.disease Combined Modality Therapy Confidence interval Radiation therapy Radiation Pneumonitis Oncology Female Radiotherapy Intensity-Modulated Radiotherapy Conformal Nuclear medicine business therapeutics Follow-Up Studies |
| Zdroj: | International journal of radiation oncology, biology, physics. 68(1) |
| ISSN: | 0360-3016 |
| Popis: | To investigate the rate of high-grade treatment-related pneumonitis (TRP) in patients with advanced non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT).From August 2002 to August 2005, 151 NSCLC patients were treated with IMRT. We excluded patients who did not receive concurrent chemotherapy or who had early-stage cancers, a history of major lung surgery, prior chest RT, a dose50 Gy, or IMRT combined with three-dimensional conformal RT (3D-CRT). Toxicities were graded by Common Terminology Criteria for Adverse Events version 3.0. Gradeor = 3 TRP for 68 eligible IMRT patients was compared with TRP among 222 similar patients treated with 3D-CRT.The median follow-up durations for the IMRT and 3D-CRT patients were 8 months (range, 0-27 months) and 9 months (range, 0-56 months), respectively. The median IMRT and 3D-CRT doses were 63 Gy. The median gross tumor volume was 194 mL (range, 21-911 mL) for IMRT, compared with 142 mL (range, 1.5-1,186 mL) for 3D-CRT (p = 0.002). Despite the IMRT group's larger gross tumor volume, the rate of Gradeor = 3 TRP at 12 months was 8% (95% confidence interval 4%-19%), compared with 32% (95% confidence interval 26%-40%) for 3D-CRT (p = 0.002).In advanced NSCLC patients treated with chemoradiation, IMRT resulted in significantly lower levels of Gradeor = 3 TRP compared with 3D-CRT. Clinical, dosimetric, and patient selection factors that may have influenced rates of TRP require continuing investigation. A randomized trial comparing IMRT with 3D-CRT has been initiated. |
| Databáze: | OpenAIRE |
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