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

• A. Fondevilla Soler ^[3] ; J. L. López-Guerra ^[1] ; M. Dzugashvili ^[3] ; P. Sempere Rincón ^[3] ; A. Sautbaet ^[2] ; P. Castañeda ^[3] ; J. M. Díaz ^[3] ; J. M. Praena-Fernandez ^[1] ; E. Rivin del Campo ^[4] ; I. Azinovic ^[5]
  1. [1] Hospital Universitario Virgen del Rocío

     Hospital Universitario Virgen del Rocío

     Sevilla, España

     
  2. [2] Universidad de Murcia

     Universidad de Murcia

     Murcia, España

     
  3. [3] Imoncology, Murcia
  4. [4] Gustave Roussy Cancer Campus. Paris, France
  5. [5] Imoncology, Madrid

  Mostrar afiliaciones +
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 19, Nº. 12, 2017, págs. 1469-1477
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • 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.