|Long-Term Clinical Outcome of Intensity-Modulated Radiotherapy for Inoperable Non-Small Cell Lung Cancer: The MD Anderson Experience|
|Jiang, Zhi-Qin5; Yang, Kunyu6; Komaki, Ritsuko; Wei, Xiong; Tucker, Susan L.3; Zhuang, Yan2; Martel, Mary K.2; Vedam, Sastray2; Balter, Peter2; Zhu, Guangying7; Gomez, Daniel; Lu, Charles4; Mohan, Radhe2; Cox, James D.; Liao, Zhongxing1|
|关键词||Non-small-cell Lung Cancer Imrt Early And Late Toxicity Radiation-induced Toxicity|
|刊名||INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS|
|WOS标题词||Science & Technology|
|类目[WOS]||Oncology ; Radiology, Nuclear Medicine & Medical Imaging|
|研究领域[WOS]||Oncology ; Radiology, Nuclear Medicine & Medical Imaging|
|关键词[WOS]||3-DIMENSIONAL CONFORMAL RADIOTHERAPY ; TREATMENT-RELATED PNEUMONITIS ; CONCURRENT CHEMOTHERAPY ; SEQUENTIAL CHEMORADIOTHERAPY ; DOSE-ESCALATION ; TARGET VOLUME ; RADIATION ; TOXICITY|
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 (TRPmax) 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 esophagitismax 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. (C) 2012 Elsevier Inc.
|作者单位||1.Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Unit 97, Houston, TX 77030 USA|
2.Univ Texas MD Anderson Canc Ctr, Dept Radiat Phys, Houston, TX 77030 USA
3.Univ Texas MD Anderson Canc Ctr, Dept Bioinformat & Computat Biol, Houston, TX 77030 USA
4.Univ Texas MD Anderson Canc Ctr, Dept Thorac Med Oncol, Houston, TX 77030 USA
5.Fudan Univ Shanghai Canc Ctr, Dept Radiat Oncol, Shanghai, Peoples R China
6.Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Ctr Canc, Wuhan 430074, Peoples R China
7.Peking Univ Sch Oncol, Beiijng Canc Hosp & Inst, Dept Radiat Oncol, Beijing, Peoples R China
|Jiang, Zhi-Qin,Yang, Kunyu,Komaki, Ritsuko,et al. Long-Term Clinical Outcome of Intensity-Modulated Radiotherapy for Inoperable Non-Small Cell Lung Cancer: The MD Anderson Experience[J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS,2012,83(1):332-339.|
|APA||Jiang, Zhi-Qin.,Yang, Kunyu.,Komaki, Ritsuko.,Wei, Xiong.,Tucker, Susan L..,...&Liao, Zhongxing.(2012).Long-Term Clinical Outcome of Intensity-Modulated Radiotherapy for Inoperable Non-Small Cell Lung Cancer: The MD Anderson Experience.INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS,83(1),332-339.|
|MLA||Jiang, Zhi-Qin,et al."Long-Term Clinical Outcome of Intensity-Modulated Radiotherapy for Inoperable Non-Small Cell Lung Cancer: The MD Anderson Experience".INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 83.1(2012):332-339.|