Locally Advanced Non-Small Cell Lung Cancer: Clinical Outcome, Toxicity and Predictive Factors in Patients Treated with Hypofractionated Sequential or Exclusive Radiotherapy.
Volumetric Modulated Arc Therapy
clinical outcome
hypofractionated radiotherapy
locally advanced non-small cell lung cancer
toxicity
Journal
Current oncology (Toronto, Ont.)
ISSN: 1718-7729
Titre abrégé: Curr Oncol
Pays: Switzerland
ID NLM: 9502503
Informations de publication
Date de publication:
12 07 2022
12 07 2022
Historique:
received:
20
05
2022
revised:
06
07
2022
accepted:
08
07
2022
entrez:
25
7
2022
pubmed:
26
7
2022
medline:
28
7
2022
Statut:
epublish
Résumé
This study evaluated the outcome, toxicity and predictive factors in patients unfit for concurrent chemo-radiotherapy (CT-RT) treated with hypofractionated sequential CT-RT or exclusive radiotherapy (RT) for locally advanced non-small cell lung cancer (LA-NSCLC). We included patients affected by LA-NSCLC (stage IIA-IVA) treated with a total dose of 50-60 Gy in 20 fractions. The primary outcomes were local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS). Univariate analysis was used to correlate outcomes with prognostic factors. Between 2011 and 2019, 210 patients were treated, 113 (53.8%) with sequential CT-RT and 97 (46.2%) with exclusive RT. After a median follow-up of 15.3 months, 74 patients (35.2%) had a local progression and 133 (63.3%) had a distant progression. The one-, two- and five-year LC were 73.6%, 55.3% and 47.9%, respectively. At the time of analysis, 167 patients (79.5%) died. The one-, two- and five-year OS were 64.7%, 36% and 20%, respectively. PTV volume correlated with PFS ( Albeit with the known limitations of a retrospective and heterogeneous study, our work shows that hypofractionated sequential CT-RT or exclusive RT offer a good local control and toxicity profile and a promising survival rate in LA-NSCLC patients unfit for the concurrent CT-RT scheme.
Sections du résumé
BACKGROUND
This study evaluated the outcome, toxicity and predictive factors in patients unfit for concurrent chemo-radiotherapy (CT-RT) treated with hypofractionated sequential CT-RT or exclusive radiotherapy (RT) for locally advanced non-small cell lung cancer (LA-NSCLC).
METHODS
We included patients affected by LA-NSCLC (stage IIA-IVA) treated with a total dose of 50-60 Gy in 20 fractions. The primary outcomes were local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS). Univariate analysis was used to correlate outcomes with prognostic factors.
RESULTS
Between 2011 and 2019, 210 patients were treated, 113 (53.8%) with sequential CT-RT and 97 (46.2%) with exclusive RT. After a median follow-up of 15.3 months, 74 patients (35.2%) had a local progression and 133 (63.3%) had a distant progression. The one-, two- and five-year LC were 73.6%, 55.3% and 47.9%, respectively. At the time of analysis, 167 patients (79.5%) died. The one-, two- and five-year OS were 64.7%, 36% and 20%, respectively. PTV volume correlated with PFS (
CONCLUSIONS
Albeit with the known limitations of a retrospective and heterogeneous study, our work shows that hypofractionated sequential CT-RT or exclusive RT offer a good local control and toxicity profile and a promising survival rate in LA-NSCLC patients unfit for the concurrent CT-RT scheme.
Identifiants
pubmed: 35877248
pii: curroncol29070388
doi: 10.3390/curroncol29070388
pmc: PMC9325151
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4893-4901Références
Int J Radiat Oncol Biol Phys. 2005 Oct 1;63(2):324-33
pubmed: 16168827
Radiother Oncol. 2020 Feb;143:58-65
pubmed: 31439448
Int J Radiat Oncol Biol Phys. 2001 Jan 1;49(1):23-33
pubmed: 11163494
Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):425-34
pubmed: 20980108
Int J Radiat Oncol Biol Phys. 2020 Jul 15;107(4):710-719
pubmed: 32275994
Radiol Med. 2019 Feb;124(2):136-144
pubmed: 30368721
Phys Med. 2019 Oct;66:55-65
pubmed: 31561206
J Thorac Oncol. 2012 Apr;7(4):716-22
pubmed: 22425920
J Clin Oncol. 2013 Dec 1;31(34):4343-8
pubmed: 24145340
J Clin Oncol. 2012 Aug 1;30(22):2788-97
pubmed: 22753901
Lancet Oncol. 2015 Feb;16(2):187-99
pubmed: 25601342
Int J Radiat Oncol Biol Phys. 2004 Nov 1;60(3):741-7
pubmed: 15465190
Clin Lung Cancer. 2015 Mar;16(2):71-9
pubmed: 25450876
Acta Oncol. 2020 Feb;59(2):164-170
pubmed: 31608751
CA Cancer J Clin. 2021 Jan;71(1):7-33
pubmed: 33433946
J Thorac Oncol. 2021 May;16(5):860-867
pubmed: 33476803
Acta Oncol. 1988;27(2):131-46
pubmed: 3390344
Lancet Oncol. 2013 Jun;14(7):619-26
pubmed: 23680111