Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer
Purpose To assess clinical outcomes and toxicities in patients with stage III unresectable non-small cell lung cancer (NSCLC) treated with a moderately escalated hypofractionated radiotherapy delivered with Helical Intensity-Modulated Technique in combination with sequential or concurrent chemothera...
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doaj-b846f4b378b5436db9a7057ff9a92a302020-11-24T22:15:15ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2013-11-01310.3389/fonc.2013.0028663430Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung CancerVittorio eDonato0Stefano eArcangeli1Alessia eMonaco2Cristina eCaruso3Michele eCianciulli4Genoveva eBoboc5Cinzia eChiostrini6Roberta eRauco7Maria Cristina ePressello8Azienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniAzienda Ospedaliera S.Camillo-ForlaniniPurpose To assess clinical outcomes and toxicities in patients with stage III unresectable non-small cell lung cancer (NSCLC) treated with a moderately escalated hypofractionated radiotherapy delivered with Helical Intensity-Modulated Technique in combination with sequential or concurrent chemotherapy.Methods and Materials Sixty-one consecutive patients considered non-progressive after 2 cycles of induction chemotherapy were treated with a moderately escalated hypofractionated radiation course of 30 daily fractions of 2.25-2.28 Gy each administered in 6 weeks up to a total dose of 67.5 Gy–68.4 Gy (range, 64.5 Gy–71.3 Gy). Thirty-two received sequential RT after 2 more cycles (total= 4 cycles) of chemotherapy, while twenty-nine were treated with concurrent chemo-radiation. The target was considered the gross tumour volume and the clinically proven nodal regions, without elective nodal irradiation. Results With a median follow up of 27 months (range 6 to 40), one-year and 2-year OS rate for all patients was 77% and 53% respectively, with a median survival duration of 18.6 months in the sequential group and 24.1 months in the concomitant group. No Grade ≥ 4 acute and late toxicity was reported. Acute Grade 3 treatment-related pneumonitis was detected in 10% of patients. Two patients, both receiving the concurrent schedule, developed a Grade 3 acute esophagitis. The overall incidence of late Grade 3 lung toxicity was 5%. No patients experienced a Grade 3 late esophageal toxicity.Conclusions A moderately hypofractionated radiation course delivered with a Helical Intensity-Modulated Technique is a feasible treatment option for patients with unresectable locally advanced NSCLC receiving chemotherapy (sequentially or concurrently). Hypofractionated radiotherapy with a dedicated technique allows safely dose escalation, minimizing the effect of tumor repopulation that may occur with prolonged treatment time.http://journal.frontiersin.org/Journal/10.3389/fonc.2013.00286/fullDose EscalationchemoradiationHypofractionated RadiotherapyUnresectable NSCLCHelical Tomotherapy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vittorio eDonato Stefano eArcangeli Alessia eMonaco Cristina eCaruso Michele eCianciulli Genoveva eBoboc Cinzia eChiostrini Roberta eRauco Maria Cristina ePressello |
spellingShingle |
Vittorio eDonato Stefano eArcangeli Alessia eMonaco Cristina eCaruso Michele eCianciulli Genoveva eBoboc Cinzia eChiostrini Roberta eRauco Maria Cristina ePressello Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer Frontiers in Oncology Dose Escalation chemoradiation Hypofractionated Radiotherapy Unresectable NSCLC Helical Tomotherapy |
author_facet |
Vittorio eDonato Stefano eArcangeli Alessia eMonaco Cristina eCaruso Michele eCianciulli Genoveva eBoboc Cinzia eChiostrini Roberta eRauco Maria Cristina ePressello |
author_sort |
Vittorio eDonato |
title |
Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer |
title_short |
Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer |
title_full |
Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer |
title_fullStr |
Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer |
title_full_unstemmed |
Moderately Escalated Hypofractionated (Chemo)Radiotherapy Delivered with Helical Intensity-Modulated Technique in Stage III Unresectable Non-Small Cell Lung Cancer |
title_sort |
moderately escalated hypofractionated (chemo)radiotherapy delivered with helical intensity-modulated technique in stage iii unresectable non-small cell lung cancer |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2013-11-01 |
description |
Purpose To assess clinical outcomes and toxicities in patients with stage III unresectable non-small cell lung cancer (NSCLC) treated with a moderately escalated hypofractionated radiotherapy delivered with Helical Intensity-Modulated Technique in combination with sequential or concurrent chemotherapy.Methods and Materials Sixty-one consecutive patients considered non-progressive after 2 cycles of induction chemotherapy were treated with a moderately escalated hypofractionated radiation course of 30 daily fractions of 2.25-2.28 Gy each administered in 6 weeks up to a total dose of 67.5 Gy–68.4 Gy (range, 64.5 Gy–71.3 Gy). Thirty-two received sequential RT after 2 more cycles (total= 4 cycles) of chemotherapy, while twenty-nine were treated with concurrent chemo-radiation. The target was considered the gross tumour volume and the clinically proven nodal regions, without elective nodal irradiation. Results With a median follow up of 27 months (range 6 to 40), one-year and 2-year OS rate for all patients was 77% and 53% respectively, with a median survival duration of 18.6 months in the sequential group and 24.1 months in the concomitant group. No Grade ≥ 4 acute and late toxicity was reported. Acute Grade 3 treatment-related pneumonitis was detected in 10% of patients. Two patients, both receiving the concurrent schedule, developed a Grade 3 acute esophagitis. The overall incidence of late Grade 3 lung toxicity was 5%. No patients experienced a Grade 3 late esophageal toxicity.Conclusions A moderately hypofractionated radiation course delivered with a Helical Intensity-Modulated Technique is a feasible treatment option for patients with unresectable locally advanced NSCLC receiving chemotherapy (sequentially or concurrently). Hypofractionated radiotherapy with a dedicated technique allows safely dose escalation, minimizing the effect of tumor repopulation that may occur with prolonged treatment time. |
topic |
Dose Escalation chemoradiation Hypofractionated Radiotherapy Unresectable NSCLC Helical Tomotherapy |
url |
http://journal.frontiersin.org/Journal/10.3389/fonc.2013.00286/full |
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