TY - JOUR
T1 - Long-term clinical outcome of intensity-modulated radiotherapy for inoperable non-small cell lung cancer
T2 - The MD Anderson experience
AU - Jiang, Zhi Qin
AU - Yang, Kunyu
AU - Komaki, Ritsuko
AU - Wei, Xiong
AU - Tucker, Susan L.
AU - Zhuang, Yan
AU - Martel, Mary K.
AU - Vedam, Sastray
AU - Balter, Peter
AU - Zhu, Guangying
AU - Gomez, Daniel
AU - Lu, Charles
AU - Mohan, Radhe
AU - Cox, James D.
AU - Liao, Zhongxing
N1 - Funding Information:
This study was supported by the Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center .
PY - 2012/5/1
Y1 - 2012/5/1
N2 - Purpose: In 2007, we published our initial experience in treating inoperable non-small-cell lung cancer (NSCLC) with intensity-modulated radiation therapy (IMRT). The current report is an update of that experience with long-term follow-up. Methods and Materials: Patients in this retrospective review were 165 patients who began definitive radiotherapy, with or without chemotherapy, for newly diagnosed, pathologically confirmed NSCLC to a dose of ≥60 Gy from 2005 to 2006. Early and late toxicities assessed included treatment-related pneumonitis (TRP), pulmonary fibrosis, esophagitis, and esophageal stricture, scored mainly according to the Common Terminology Criteria for Adverse Events 3.0. Other variables monitored were radiation-associated dermatitis and changes in body weight and Karnofsky performance status. The Kaplan-Meier method was used to compute survival and freedom from radiation-related acute and late toxicities as a function of time. Results: Most patients (89%) had Stage III to IV disease. The median radiation dose was 66 Gy given in 33 fractions (range, 60-76 Gy, 1.8-2.3 Gy per fraction). Median overall survival time was 1.8 years; the 2-year and 3-year overall survival rates were 46% and 30%. Rates of Grade ≥3 maximum TRP (TRP max) were 11% at 6 months and 14% at 12 months. At 18 months, 86% of patients had developed Grade ≥1 maximum pulmonary fibrosis (pulmonary fibrosis max) and 7% Grade ≥2 pulmonary fibrosis max. The median times to maximum esophagitis (esophagitis max) were 3 weeks (range, 1-13 weeks) for Grade 2 and 6 weeks (range, 3-13 weeks) for Grade 3. A higher percentage of patients who experienced Grade 3 esophagitis max later developed Grade 2 to 3 esophageal stricture. Conclusions: In our experience, using IMRT to treat NSCLC leads to low rates of pulmonary and esophageal toxicity, and favorable clinical outcomes in terms of survival.
AB - Purpose: In 2007, we published our initial experience in treating inoperable non-small-cell lung cancer (NSCLC) with intensity-modulated radiation therapy (IMRT). The current report is an update of that experience with long-term follow-up. Methods and Materials: Patients in this retrospective review were 165 patients who began definitive radiotherapy, with or without chemotherapy, for newly diagnosed, pathologically confirmed NSCLC to a dose of ≥60 Gy from 2005 to 2006. Early and late toxicities assessed included treatment-related pneumonitis (TRP), pulmonary fibrosis, esophagitis, and esophageal stricture, scored mainly according to the Common Terminology Criteria for Adverse Events 3.0. Other variables monitored were radiation-associated dermatitis and changes in body weight and Karnofsky performance status. The Kaplan-Meier method was used to compute survival and freedom from radiation-related acute and late toxicities as a function of time. Results: Most patients (89%) had Stage III to IV disease. The median radiation dose was 66 Gy given in 33 fractions (range, 60-76 Gy, 1.8-2.3 Gy per fraction). Median overall survival time was 1.8 years; the 2-year and 3-year overall survival rates were 46% and 30%. Rates of Grade ≥3 maximum TRP (TRP max) were 11% at 6 months and 14% at 12 months. At 18 months, 86% of patients had developed Grade ≥1 maximum pulmonary fibrosis (pulmonary fibrosis max) and 7% Grade ≥2 pulmonary fibrosis max. The median times to maximum esophagitis (esophagitis max) were 3 weeks (range, 1-13 weeks) for Grade 2 and 6 weeks (range, 3-13 weeks) for Grade 3. A higher percentage of patients who experienced Grade 3 esophagitis max later developed Grade 2 to 3 esophageal stricture. Conclusions: In our experience, using IMRT to treat NSCLC leads to low rates of pulmonary and esophageal toxicity, and favorable clinical outcomes in terms of survival.
KW - Early and late toxicity
KW - IMRT
KW - Non-small-cell lung cancer
KW - Radiation-induced toxicity
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U2 - 10.1016/j.ijrobp.2011.06.1963
DO - 10.1016/j.ijrobp.2011.06.1963
M3 - Article
C2 - 22079735
AN - SCOPUS:84859832006
SN - 0360-3016
VL - 83
SP - 332
EP - 339
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -