| XU Yu-jin,LIU Guan,WANG Zhun,et al.Simultaneously integrated boost intensity-modulated radiotherapy for locally advanced non-small cell lung cancer:A retrospective study of 78 patients[J].Chinese Journal of Radiological Medicine and Protection,2013,33(2):146-150 |
| Simultaneously integrated boost intensity-modulated radiotherapy for locally advanced non-small cell lung cancer:A retrospective study of 78 patients |
| Received:December 04, 2012 |
| DOI：10.3760/cma.j.issn.0254-5098.2013.02.009 |
| KeyWords:Non-small cell lung cancer Integrated boost intensity-modulated radiotherapy Overall survival rate Adverse events |
| FundProject: |
| Author Name | Affiliation | E-mail | | XU Yu-jin | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | LIU Guan | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | WANG Zhun | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | ZHENG Xiao | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | WANG Yue-zhen | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | FENG Wei | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | LAI Xiao-jing | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | ZHOU Xia | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | BAI Xue | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | MA Hong-lian | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | ZHANG Na | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | WANG Jin | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | HU Xiao | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | | | CHEN Ming | Department of Radiation Oncology, Zhejiang Cancer Hospital,Hangzhou 310022,China | chenming@sysucc.org.cn |
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| Abstract:: |
| Objective To evaluate the clinical efficacy and toxicity of simultaneously integrated boost intensity-modulated radiotherapy (SIB-IMRT) for patients with locally advanced non-small cell lung cancer (NSCLC). Methods Patients with NSCLC who received SIB-IMRT from January 2008 to June 2011 in our hospital were retrospectively analyzed. Among the 78 patients, 45 patients had clinical stage IIIA disease, 33 patients IIIB disease. The SIB-IMRT plans were designed to deliver 50.4-64.0 Gy in 28-33 fractions (1.8-2.1 Gy/fraction) to PTV while simultaneously delivering 60.0-74.3 Gy in 28-33 fractions(2.0-2.5 Gy/fraction) to IGTV. The primary endpoint was overall survival (OS).The secondary endpoints were overall response rate (ORR), local control rate (LCR), progression-free survival (PFS), adverse events (AEs). Results All patients completed definitive radiotherapy and 67(85.9%)patients received platinum-based doublet chemotherapy. Among them, 17(21.8%)received concurrent chemoradiation,other 50(64.1%)received sequential chemoradiation. The ORR was 69.2%(54/78), with CR 11(14.1%), PR 43(55.1%), SD 22(28.2%), PD 2(2.6%). The follow-up rate was 92.3%. Among 72 patients who were followed up, 50 were dead, 22 were alive.1,2,3-year LCR were 88.4%,54.7%,28.6%. Median OS and PFS were 27.3 months(5.8-49.3 months),15.3 months(2.3-46.8 months),respectively.1,2,3-year OS and PFS were 87.5%,50.7%,56.6%,27.6%,30.3% and 21.1%,respectively. There was a statistically significant difference in OS between the sub-group arms with concurrent chemoradiation or non-concurrent chemoradiation (χ2=3.946,P＜0.05). Nineteen (24.4%) patients experienced acute grade 3 esophagitis and 9(11.5%) experienced acute grade≥3 treatment-related pneumonitis (TRP). There were 2 (2.6%) late grade 3 pulmonary toxicity after 1-year follow-up. No late grade≥3 esophageal toxicity was observed. Conclusions It is safe and workable to use SIB-IMRT to treat patients with NSCLC. More prospective clinical studies are warranted. |
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