A Comparison of Radiation Techniques in Patients Treated With Concurrent Chemoradiation for Stage III Non-Small Cell Lung Cancer
| Autor: | Greg Pond, Anand Swaminath, Peter M. Ellis, Jonathan Peng, Elysia Donovan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Adolescent medicine.medical_treatment Population Kaplan-Meier Estimate 030218 nuclear medicine & medical imaging Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Internal medicine Carcinoma medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) education Aged Neoplasm Staging Retrospective Studies Aged 80 and over education.field_of_study Radiation Performance status Proportional hazards model business.industry Radiotherapy Dosage Retrospective cohort study Chemoradiotherapy Middle Aged medicine.disease Confidence interval Radiation therapy Treatment Outcome 030220 oncology & carcinogenesis Female Radiotherapy Intensity-Modulated business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 106:985-992 |
| ISSN: | 0360-3016 |
| Popis: | Purpose The standard of care in management of patients with good performance status and unresectable stage III non-small cell lung cancer (NSCLC) therapy is concurrent chemoradiation. Newer techniques such as intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) are replacing 3-dimensional conformal radiation (3DCRT) despite low-quality evidence of improved outcomes. We used population-based data to examine survival outcomes by radiation technique. Methods and Materials A population-based retrospective cohort of patients with stage III NSCLC treated with concurrent chemoradiation from 2009 to 2017 in Ontario were identified. The primary outcome was a comparison of overall survival among 3DCRT, IMRT, and VMAT, calculated using the Kaplan-Meier method and compared using log-rank test. Cox regression was used to investigate effect of radiation type on overall survival adjusted for other covariates. Results A total of 3872 patients were treated with 3DCRT (n = 1178), IMRT (n = 1847), or VMAT (n = 847). A decline in 3DCRT and increase in VMAT use were observed over time. Median survival in months was 21.2 (95% confidence interval [CI], 20.0-22.8) for 3DCRT, 23.9 (95% CI, 22.3-25.6) for IMRT, and 24.9 (95% CI, 22.5-27.4) for VMAT, but these differences were not statistically significant (P = .06). Conclusions Our study demonstrates that survival is not compromised in patients receiving IMRT or VMAT (compared with 3DCRT). Thus, given the potential dosimetric advantages associated with these techniques, VMAT and IMRT are recommended for the management of patients with stage III NSCLC. |
| Databáze: | OpenAIRE |
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