Computed Tomography–Guided Interstitial High-Dose-Rate Brachytherapy in Combination With Regional Positive Lymph Node Intensity-Modulated Radiation Therapy in Locally Advanced Peripheral Non–Small Cell Lung Cancer: A Phase 1 Clinical Trial
| Autor: | Li-Jia He, Huai-Lin He, Changling Shang, Yue Chen, Haowen Pang, Jing-Bo Wu, Hui-qun Luo, Qinglian Wen, Jianwen Zhang, Hong-Ru Yang, Sheng Lin, Bo Yang, PeiRong Ren, Li Xiang |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Lung Neoplasms Time Factors Paclitaxel medicine.medical_treatment Brachytherapy Phases of clinical research Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols Carcinoma Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Lung cancer Survival rate Aged Etoposide Aged 80 and over Radiation business.industry Remission Induction Pneumothorax Radiotherapy Dosage Middle Aged medicine.disease Combined Modality Therapy High-Dose Rate Brachytherapy Survival Rate Radiation therapy Oncology Female Radiotherapy Intensity-Modulated Radiology Lymph Cisplatin Safety business Follow-Up Studies Radiotherapy Image-Guided |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 92:1027-1034 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2015.04.019 |
| Popis: | Purpose To assess the technical safety, adverse events, and efficacy of computed tomography (CT)-guided interstitial high-dose-rate (HDR) brachytherapy in combination with regional positive lymph node intensity modulated radiation therapy in patients with locally advanced peripheral non–small cell lung cancer (NSCLC). Methods and Materials Twenty-six patients with histologically confirmed NSCLC were enrolled in a prospective, officially approved phase 1 trial. Primary tumors were treated with HDR brachytherapy. A single 30-Gy dose was delivered to the 90% isodose line of the gross lung tumor volume. A total dose of at least 70 Gy was administered to the 95% isodose line of the planning target volume of malignant lymph nodes using 6-MV X-rays. The patients received concurrent or sequential chemotherapy. We assessed treatment efficacy, adverse events, and radiation toxicity. Results The median follow-up time was 28 months (range, 7-44 months). There were 3 cases of mild pneumothorax but no cases of hemothorax, dyspnea, or pyothorax after the procedure. Grade 3 or 4 acute hematologic toxicity was observed in 5 patients. During follow-up, mild fibrosis around the puncture point was observed on the CT scans of 2 patients, but both patients were asymptomatic. The overall response rates (complete and partial) for the primary mass and positive lymph nodes were 100% and 92.3%, respectively. The 1-year and 2-year overall survival (OS) rates were 90.9% and 67%, respectively, with a median OS of 22.5 months. Conclusion Our findings suggest that HDR brachytherapy is safe and feasible for peripheral locally advanced NSCLC, justifying a phase 2 clinical trial. |
| Databáze: | OpenAIRE |
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