Association between intensity modulated radiotherapy and survival in patients with stage III non-small cell lung cancer treated with chemoradiotherapy

Autor: Chad G. Rusthoven, Matthew Koshy, David J. Sher, Michael T. Spiotto, Renuka Malik, Usama Mahmood
Rok vydání: 2017
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
Oncology
Cancer Research
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
Comorbidity
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Carcinoma
Non-Small-Cell Lung
Internal medicine
Odds Ratio
otorhinolaryngologic diseases
medicine
Humans
In patient
Lung cancer
neoplasms
Aged
Neoplasm Staging
Aged
80 and over
Lung
business.industry
Disease Management
Radiotherapy Dosage
Chemoradiotherapy
Middle Aged
medicine.disease
Combined Modality Therapy
Stage III Non-Small Cell Lung Cancer
Radiation therapy
stomatognathic diseases
Treatment Outcome
medicine.anatomical_structure
Socioeconomic Factors
Tolerability
030220 oncology & carcinogenesis
Cohort
Female
Dose Fractionation
Radiation
Radiotherapy
Intensity-Modulated
business
therapeutics
Zdroj: Lung Cancer. 108:222-227
ISSN: 0169-5002
Popis: To determine the effect of radiotherapy (RT) technique on treatment compliance and overall survival (OS) in patients with stage III non-small lung cancer (NSCLC) treated with definitive chemoradiotherapy (CRT).This study included patients with stage III NSCLC in the National Cancer Database treated between 2003 and 2011 with definitive CRT to 60-63 Gray (Gy). Radiation treatment interruption (RTI) was defined as a break of ≥4 days. Treatment technique was dichotomized as intensity modulated (IMRT) or non-IMRT techniques.Out of the cohort of 7492, 35% had a RTI and 10% received IMRT. With a median follow-up of surviving patients of 32 months, the median survival for those with non-IMRT vs. IMRT was 18.2 months vs. 20 months (p0.0001). Median survival for those with and without an RTI≥4 days was 16.1 months vs. 19.8 months (p0.0001). Use of IMRT predicted for a decreased likelihood of RTI (odds ratio, 0.84, p=0.04). On multivariable analysis for OS, IMRT had a HR of 0.89 (95% CI: 0.80-0.98, p=0.01) and RTI had a HR of 1.2 (95% confidence interval (CI): 1.14-1.27, p=0.001).IMRT was associated with small but significant survival advantage for patients with stage III NSCLC treated with CRT. A RTI led to inferior survival, and both IMRT and RTI were independently associated with OS. Additional research should investigate whether improved tolerability, reduced normal tissue exposure, or superior coverage drives the association between IMRT and improved survival.
Databáze: OpenAIRE
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