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Published in: Clinical and Translational Oncology 12/2017

01-12-2017 | Research Article

Outcome and toxicity of intensity modulated radiotherapy with simultaneous integrated boost in locally advanced non-small cell lung cancer patients

Authors: A. Fondevilla Soler, J. L. López-Guerra, M. Dzugashvili, P. Sempere Rincón, A. Sautbaet, P. Castañeda, J. M. Díaz, J. M. Praena-Fernandez, E. Rivin del Campo, I. Azinovic

Published in: Clinical and Translational Oncology | Issue 12/2017

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Abstract

Purpose

The aim of this study was to assess the feasibility and treatment outcome of intensity modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) in locally advanced non-small cell lung cancer (NSCLC) patients.

Materials and methods

A total of 64 NSCLC patients with stage IIB (3%), IIIA (36%), and IIIB (61%) were treated with concomitant (N = 47; 73%) or sequential (N = 9; 14%) chemotherapy between February 2009 and January 2014. Eight patients (13%) received RT alone. All patients received the same irradiation scheme using IMRT: prophylactic dose for mediastinum was 56 Gy at 1.65 Gy/fraction and SIB to macroscopic disease up to 68 Gy at 2 Gy/fraction.

Results

The median follow-up was 16 months (range, 1–70 months). The overall survival rate for all patients was 79% after 1 year and 46% after 2 years. Disease-free survival (DFS) was 81 and 45% after 1 and 2 years, respectively, resulting in a median DFS of 16 months. Multivariate analysis showed a statistically significant association between stage IIIB patients and a higher risk of mortality (HR 2.11; P = 0.019). In addition, T4 stage associated with higher risk of recurrence (HR 2.23; P = 0.024) while concomitant chemoradiation was associated with lower risk of any recurrence (HR 0.34; P = 0.004) No patient experienced grade ≥3 esophagitis and only 6 cases (9%) had grade 3 pneumonitis. Only having a higher lung volume was associated with higher risk of pneumonitis in the multivariate analysis (HR 16.21; P = 0.022).

Conclusion

This study in advanced NSCLC patients shows that SIB-IMRT is an effective technique with acceptable toxicity, also when combined with chemotherapy.
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Metadata
Title
Outcome and toxicity of intensity modulated radiotherapy with simultaneous integrated boost in locally advanced non-small cell lung cancer patients
Authors
A. Fondevilla Soler
J. L. López-Guerra
M. Dzugashvili
P. Sempere Rincón
A. Sautbaet
P. Castañeda
J. M. Díaz
J. M. Praena-Fernandez
E. Rivin del Campo
I. Azinovic
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 12/2017
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-017-1689-z

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