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01-03-2015 | Original article

DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily

High local control in early stage (I/II) non-small-cell lung cancer

Authors: Franz Zehentmayr, M.D., M.Sc., Karl Wurstbauer, M.D., Heinz Deutschmann, M.Sc., Christoph Fussl, M.D., Peter Kopp, Ph.D., Karin Dagn, M.D., Gerd Fastner, M.D., Peter Porsch, M.D., Michael Studnicka, M.D., Felix Sedlmayer, M.D.

Published in: Strahlentherapie und Onkologie | Issue 3/2015

Abstract

Background

While surgery is considered standard of care for early stage (I/II), non-small-cell lung cancer (NSCLC), radiotherapy is a widely accepted alternative for medically unfit patients or those who refuse surgery. International guidelines recommend several treatment options, comprising stereotactic body radiation therapy (SBRT) for small tumors, conventional radiotherapy ≥ 60 Gy for larger sized especially centrally located lesions or continuous hyperfractionated accelerated RT (CHART). This study presents clinical outcome and toxicity for patients treated with a dose-differentiated accelerated schedule using 1.8 Gy bid (DART-bid).

Patients and methods

Between April 2002 and December 2010, 54 patients (median age 71 years, median Karnofsky performance score 70 %) were treated for early stage NSCLC. Total doses were applied according to tumor diameter: 73.8 Gy for < 2.5 cm, 79.2 Gy for 2.5–4.5 cm, 84.6 Gy for 4.5–6 cm, 90 Gy for > 6 cm.

Results

The median follow-up was 28.5 months (range 2–108 months); actuarial local control (LC) at 2 and 3 years was 88 %, while regional control was 100 %. There were 10 patients (19 %) who died of the tumor, and 18 patients (33 %) died due to cardiovascular or pulmonary causes. A total of 11 patients (20 %) died intercurrently without evidence of progression or treatment-related toxicity at the last follow-up, while 15 patients (28 %) are alive. Acute esophagitis ≤ grade 2 occurred in 7 cases, 2 patients developed grade 2 chronic pulmonary fibrosis.

Conclusion

DART-bid yields high LC without significant toxicity. For centrally located and/or large (> 5 cm) early stage tumors, where SBRT is not feasible, this method might serve as radiotherapeutic alternative to present treatment recommendations, with the need of confirmation in larger cohorts.

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Title: DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily
High local control in early stage (I/II) non-small-cell lung cancer
Authors: Franz Zehentmayr, M.D., M.Sc.
Karl Wurstbauer, M.D.
Heinz Deutschmann, M.Sc.
Christoph Fussl, M.D.
Peter Kopp, Ph.D.
Karin Dagn, M.D.
Gerd Fastner, M.D.
Peter Porsch, M.D.
Michael Studnicka, M.D.
Felix Sedlmayer, M.D.
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 3/2015
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0754-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily

High local control in early stage (I/II) non-small-cell lung cancer

Abstract

Background

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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