scholarly journals Hypofractionated Volumetric-Modulated Arc Radiotherapy for Patients With Non-Small-Cell Lung Cancer Not Suitable for Surgery or Conventional Chemoradiotherapy or SBRT

2021 ◽  
Vol 11 ◽  
Author(s):  
Junyue Shen ◽  
Dan Yang ◽  
Mailin Chen ◽  
Leilei Jiang ◽  
Xin Dong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Local Recurrence ◽  
Small Cell Lung Cancer ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Alternative Treatment ◽  
Small Cell ◽  
Small Cell Lung ◽  
Definitive Therapy ◽  
Volumetric Modulated Arc Radiotherapy

BackgroundHypofractionated radiotherapy (HypoRT) has been used to pursue an alternative treatment regimen for patients with non-small-cell lung cancer (NSCLC) who are not eligible for stereotactic ablative radiotherapy (SABR), surgery or concurrent chemoradiotherapy (CCRT) and has shown good local control and safety. We analyzed the feasibility of using volumetric-modulated arc radiotherapy (VMAT) with the simultaneous integrated boost (SIB) technique to achieve high local control with few treatment-related toxicities.Patients and MethodsA total of 55 patients with stage I-IV NSCLC who were not candidates for SABR, surgery or CCRT were included in the present study. All patients received a prescribed dose of 60 to 66 Gy in 15 fractions. Local progression-free survival (LPFS), PFS, overall survival (OS), and toxicities were retrospectively analyzed.ResultsThirty-three patients (60.0%) had stage IV or recurrent disease in this study. The median follow-up time was 8 months (interquartile range: 5.0-16.3 months). The 1-year and 2-year OS rates were 84.3% and 69.9%, and the 1-year and 2-year LPFS rates were 91.0% and 63.0%. The median OS (mOS) and median LPFS (mLPFS) were not reached, and median PFS (mPFS) was 15 months. Twenty-eight (51.9%) patients had disease progression at the time of analysis. Of these, 7 (13.0%), 7 (13.0%) and 21 (38.9%) had local recurrence, locoregional failure and distant metastasis, respectively. All cases of local recurrence were found within the SIB region. Four patients had grade 2-3 pneumonitis, and 8 patients had grade 2-3 esophagitis. Patients with grade 2-3 esophagitis had significantly higher maximum dose and dose to 5 cm3 volume to esophagus than those with grade 0-1 esophagitis. No grade 4 or higher toxicity was observed.ConclusionThe 60 to 66 Gy in 15 fractions RT regimen provides favorable local control and survival with well-tolerated toxicities. Hypofractionated VMAT+SIB is an alternative treatment option for patients with NSCLC who cannot tolerate standard definitive therapy.

scholarly journals Radiotherapy for local recurrence of non-small-cell lung cancer after lobectomy and lymph node dissection—can local recurrence be radically cured by radiation?

2020 ◽  
Vol 50 (4) ◽  
pp. 425-433
Author(s):  
Yukihiro Terada ◽  
Mitsuhiro Isaka ◽  
Hideyuki Harada ◽  
Hayato Konno ◽  
Hideaki Kojima ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung

Abstract Background There is no standard therapeutic approach for local recurrence of non-small cell lung cancer (NSCLC) after complete resection. We investigated the outcomes of radiotherapy (RT) for patients with local recurrence. Methods We reviewed 46 patients who underwent curative-intent RT for local recurrence after lobectomy or pneumonectomy accompanied with mediastinal lymph node dissection between 2002 and 2014. We analyzed overall survival (OS), progression-free survival (PFS), local control, tumour response and the re-recurrence pattern. Results Among the 46 patients, 16 received concurrent chemotherapy. The median follow-up period was 48 months. The response rate was 91%. The 5-year OS and local control rates were 47.9 and 65.3%, respectively, and the 5-year PFS rate was 22.8%. Female sex and complete response to radiation were favourable prognostic factors. Of the 33 patients with recurrence after radiation, 32 (97%) had distant metastasis. Conclusions Although RT for local recurrence has high efficacy, distant relapse after radiation remains a major issue. Therefore, combination systemic therapy for local recurrence at any site should be further investigated. Since it is difficult to achieve a radical cure for local recurrence using RT, further study, for the administration of post-operative adjuvant therapy, is recommended.

Local Control and Survival Following Concomitant Chemoradiotherapy in Inoperable Stage I Non-Small-Cell Lung Cancer

2009 ◽  
Vol 74 (5) ◽  
pp. 1371-1375 ◽  
Author(s):  
Marie-Pierre Campeau ◽  
Alan Herschtal ◽  
Greg Wheeler ◽  
Michael Mac Manus ◽  
Andrew Wirth ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Concomitant Chemoradiotherapy

scholarly journals Tumor volume shrinkage during stereotactic body radiotherapy is related to better prognoses in patients with stage I non-small-cell lung cancer

2020 ◽  
Vol 61 (5) ◽  
pp. 740-746
Author(s):  
Nam Vu ◽  
Hiroshi Onishi ◽  
Masahide Saito ◽  
Kengo Kuriyama ◽  
Takafumi Komiyama ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Tumor Volume ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Volume Changes

Abstract The purpose of the study was to investigate the association between tumor volume changes during stereotactic body radiation therapy (SBRT) and prognoses in stage I non-small-cell lung cancer (NSCLC). This retrospective review included stage I NSCLC patients in whom SBRT was performed at a total dose of 48.0–50.5 Gy in four or five fractions. The tumor volumes observed on computed tomography (CT) simulation and on the CT performed at the last treatment session using a CT-on-rails system were measured and compared. Then, the tumor volume changes during the SBRT period were measured and assessed for their association with prognoses (overall survival, local control, lymph node metastases and distant metastases). A total of 98 patients with a mean age of 78.6 years were enrolled in the study. The T-stage was T1a in 42%, T1b in 32% and T2a in 26% of the cases. The gross tumor volume (GTV) shrank and increased ≥10% in 23 (23.5%) and 36 (36.7%) of the cases, respectively. The 5-year local control and overall survival rates in the groups with a tumor shrinkage of ≥10% vs the group with a shrinkage of <10% were 94.7 vs 70.8% and 85.4 vs 47.6%, respectively; these differences were significant, with a P-value < 0.05. During a short SBRT period, the tumor shrank or enlarged in a small number of cases. A decrease of ≥10% in the GTV during SBRT was significantly related to better overall survival and local control.

Sign in / Sign up

Export Citation Format

Share Document