J Cancer 2018; 9(15):2625-2630. doi:10.7150/jca.24976
Preliminary Results about Application of Intensity-Modulated Radiotherapy to Reduce Prophylactic Radiation Dose in Limited-Stage Small Cell Lung Cancer
Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, and Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, P.R. China.
Co-first Author: Jing Wang
Liu Z, Wang J, Yuan Z, Zhang B, Gong L, Zhao L, Wang P. Preliminary Results about Application of Intensity-Modulated Radiotherapy to Reduce Prophylactic Radiation Dose in Limited-Stage Small Cell Lung Cancer. J Cancer 2018; 9(15):2625-2630. doi:10.7150/jca.24976. Available from http://www.jcancer.org/v09p2625.htm
To evaluate the clinical outcomes of simultaneous dose reduction of elective nodal area with intensity-modulated radiotherapy (SIR-IMRT) versus conventional IMRT (C-IMRT) in patients with limited-stage small-cell lung cancer (LS-SCLC), patients with LS-SCLC who received definitive SIR-IMRT or C-IMRT were retrospectively analyzed. In SIR-IMRT group, the prescribed dose was 60Gy to the planning gross target volume (PTVG), and 54Gy to the planning target volume (PTV). In the C-IMRT group, the prescribed dose was 60Gy to the whole PTV. Radiation-related toxicities were estimated according to Common Terminology Criteria for Adverse Events (version 3.0). The primary endpoint was loco-regional recurrence-free survival (LRFS), and the secondary endpoints include overall survival (OS) and toxicities. LRFS and OS were estimated with Kaplan-Meier method. After propensity score matching, 84 patients were included in this study, with 42 patients in each group. Fifty-eight patients experienced treatment failure. Grade 3 and above radiation-induced lung toxicity developed in 2 patients in SIR-IMRT group and 5 patients in C-IMRT group, respectively. Grade 3 and above radiation-related esophagitis was observed in 3 patients and 5 patients, respectively. The 1-, 3-year LRFS rates of the SIR-IMRT group and C-IMRT group were 90.4%, 73.3% and 87.1%, 45.0%(P=0.025), respectively. Reducing the irradiation dose to the elective nodal region may reduce radiation-induced toxicities without compromising local-regional control and overall survival.
Keywords: Small-cell lung cancer, Radiation therapy, Intensity-modulated radiotherapy