Efficacy and Tolerability of Palliative Split-Course Thoracic Chemoradiotherapy for Symptomatic Non–Small Cell Lung Cancer
| Autor: | Jennifer Young, David J. Sher, Mary J. Fidler, Marta Batus, Philip Bonomi, K Kiel, Virag Dandekar |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Chest Pain Hemoptysis Cancer Research medicine.medical_specialty Lung Neoplasms Palliative care Paclitaxel medicine.medical_treatment Pemetrexed Adenocarcinoma Carboplatin Cohort Studies Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols medicine Esophagitis Humans Cumulative incidence Radiation Injuries Lung cancer Aged Etoposide Retrospective Studies Pneumonitis Performance status business.industry Palliative Care Chemoradiotherapy Middle Aged medicine.disease Surgery Radiation Pneumonitis Radiation therapy Dyspnea Treatment Outcome Cough Oncology Tolerability Carcinoma Squamous Cell Female business |
| Zdroj: | American Journal of Clinical Oncology. 38:605-609 |
| ISSN: | 0277-3732 |
| Popis: | Introduction To assess the efficacy and tolerability of palliative split-course concurrent thoracic chemoradiotherapy (CRT) in patients with incurable locally advanced and metastatic non-small cell lung cancer. Methods All patients with incurable non-small cell lung cancer and symptomatic thoracic disease treated with palliative split-course CRT between March 2006 and February 2013 at a single institution were included in this retrospective study. The primary endpoint was improvement in presenting thoracic symptoms. Secondary endpoints included toxicity, overall survival, and the cumulative incidence of locoregional failure. Results Fifty-five patients were identified, of whom 89% had distant metastatic disease at the initiation of treatment. The median radiotherapy dose delivered was 40 Gy over 20 fractions. Over 90% of patients were able to complete at least 2 cycles of chemotherapy, and 89% of patients completed the prescribed course of radiotherapy. Forty percent of patients had improvement in all presenting symptoms and 78% experienced improvement in at least 1 symptom. Nine and 2 patients, respectively, experienced grade 1 and 2 esophagitis and 1 patient experienced grade 2 pneumonitis. There were no cases of grade 3 toxicity. With a median follow-up for surviving patients of 4.5 months, the estimated actuarial 6-, 12-, and 24-month overall survival was 56%, 25%, and 13%, respectively. The actuarial 6-, 12-, and 24-month cumulative incidence of locoregional failure was 6%, 14%, and 22%, respectively. Discussion Split-course CRT allows for early introduction of systemic therapy while providing durable locoregional control with tolerable morbidity and significant improvement in chest symptomatology. This paradigm is a viable model for chest palliation in selected patients with intact performance status. |
| Databáze: | OpenAIRE |
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