Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer
Low survival outcomes have been reported for the treatment of locally advanced non small cell lung cancer (LA-NSCLC) with the standard of care treatment of concurrent chemoradiation (cCRT). We present our experience of dose escalation using stereotactic body radiosurgery (SBRT) following conventiona...
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| Veröffentlicht in: | Radiation oncology (London, England) England), 2013-07, Vol.8 (1), p.179-179, Article 179 |
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| creator | Karam, Sana D Horne, Zachary D Hong, Robert L McRae, Don Duhamel, David Nasr, Nadim M |
| description | Low survival outcomes have been reported for the treatment of locally advanced non small cell lung cancer (LA-NSCLC) with the standard of care treatment of concurrent chemoradiation (cCRT). We present our experience of dose escalation using stereotactic body radiosurgery (SBRT) following conventional cCRT for patients with LA-NSCLC.
Sixteen patients with a median age of 67.5 treated with fractionated SBRT from 2010 to 2012 were retrospectively analyzed. Nine (56%) of the patients had stage IIIB, 6 (38%) has stage IIIA, and 1 (6%) had recurrent disease. Majority of the patients (63%) presented with N2 disease. All patients had a PET CT for treatment planning. Patients received conventional cCRT to a median dose of 50.40 Gy (range 45-60) followed by an SBRT boost with an average dose of 25 Gy (range 20-30) given over 5 fractions.
With a median follow-up of 14 months (range, 1-14 months), 1-year overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC), and distant control (DC) rates were, 78%, 42%, 76%, 79%, and 71%, respectively. Median times to disease progression and regional failure were 10 months and 18 months, respectively. On univariate analysis, advanced age and nodal status were worse prognostic factors of PFS (p |
| doi_str_mv | 10.1186/1748-717X-8-179 |
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Sixteen patients with a median age of 67.5 treated with fractionated SBRT from 2010 to 2012 were retrospectively analyzed. Nine (56%) of the patients had stage IIIB, 6 (38%) has stage IIIA, and 1 (6%) had recurrent disease. Majority of the patients (63%) presented with N2 disease. All patients had a PET CT for treatment planning. Patients received conventional cCRT to a median dose of 50.40 Gy (range 45-60) followed by an SBRT boost with an average dose of 25 Gy (range 20-30) given over 5 fractions.
With a median follow-up of 14 months (range, 1-14 months), 1-year overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC), and distant control (DC) rates were, 78%, 42%, 76%, 79%, and 71%, respectively. Median times to disease progression and regional failure were 10 months and 18 months, respectively. On univariate analysis, advanced age and nodal status were worse prognostic factors of PFS (p < 0.05). Four patients developed radiation pneumonitis and one developed hemoptysis. Treatment was interrupted in one patient who required hospitalization due to arrhythmias and pneumonia.
Risk adaptive dose escalation with SBRT following external beam radiotherapy is possible and generally tolerated treatment option for patients with LA-NSCLC.</description><identifier>ISSN: 1748-717X</identifier><identifier>EISSN: 1748-717X</identifier><identifier>DOI: 10.1186/1748-717X-8-179</identifier><identifier>PMID: 23842112</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Aged, 80 and over ; Cancer therapies ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - surgery ; Chemoradiotherapy - methods ; Chemotherapy ; Clinical trials ; Disease-Free Survival ; Female ; Fiducial Markers ; Health aspects ; Humans ; Kaplan-Meier Estimate ; Lung cancer ; Lung cancer, Non-small cell ; Lung Neoplasms - mortality ; Lung Neoplasms - surgery ; Male ; Medical imaging ; Medical treatment ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Patient outcomes ; Patients ; Proportional Hazards Models ; Radiation ; Radiation dosimetry ; Radiation therapy ; Radiometry ; Radiosurgery - adverse effects ; Radiosurgery - methods ; Radiotherapy ; Radiotherapy Planning, Computer-Assisted - methods ; Tomography</subject><ispartof>Radiation oncology (London, England), 2013-07, Vol.8 (1), p.179-179, Article 179</ispartof><rights>COPYRIGHT 2013 BioMed Central Ltd.</rights><rights>2013 Karam et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2013 Karam et al.; licensee BioMed Central Ltd. 2013 Karam et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-d24692f4f566da5e1ed7216bb7bc221ea552739b4da683614cff1a8ed6034f253</citedby><cites>FETCH-LOGICAL-c521t-d24692f4f566da5e1ed7216bb7bc221ea552739b4da683614cff1a8ed6034f253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720211/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720211/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23842112$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karam, Sana D</creatorcontrib><creatorcontrib>Horne, Zachary D</creatorcontrib><creatorcontrib>Hong, Robert L</creatorcontrib><creatorcontrib>McRae, Don</creatorcontrib><creatorcontrib>Duhamel, David</creatorcontrib><creatorcontrib>Nasr, Nadim M</creatorcontrib><title>Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer</title><title>Radiation oncology (London, England)</title><addtitle>Radiat Oncol</addtitle><description>Low survival outcomes have been reported for the treatment of locally advanced non small cell lung cancer (LA-NSCLC) with the standard of care treatment of concurrent chemoradiation (cCRT). We present our experience of dose escalation using stereotactic body radiosurgery (SBRT) following conventional cCRT for patients with LA-NSCLC.
Sixteen patients with a median age of 67.5 treated with fractionated SBRT from 2010 to 2012 were retrospectively analyzed. Nine (56%) of the patients had stage IIIB, 6 (38%) has stage IIIA, and 1 (6%) had recurrent disease. Majority of the patients (63%) presented with N2 disease. All patients had a PET CT for treatment planning. Patients received conventional cCRT to a median dose of 50.40 Gy (range 45-60) followed by an SBRT boost with an average dose of 25 Gy (range 20-30) given over 5 fractions.
With a median follow-up of 14 months (range, 1-14 months), 1-year overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC), and distant control (DC) rates were, 78%, 42%, 76%, 79%, and 71%, respectively. Median times to disease progression and regional failure were 10 months and 18 months, respectively. On univariate analysis, advanced age and nodal status were worse prognostic factors of PFS (p < 0.05). Four patients developed radiation pneumonitis and one developed hemoptysis. Treatment was interrupted in one patient who required hospitalization due to arrhythmias and pneumonia.
Risk adaptive dose escalation with SBRT following external beam radiotherapy is possible and generally tolerated treatment option for patients with LA-NSCLC.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer therapies</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Chemoradiotherapy - methods</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Fiducial Markers</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung cancer</subject><subject>Lung cancer, Non-small cell</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Radiation</subject><subject>Radiation dosimetry</subject><subject>Radiation therapy</subject><subject>Radiometry</subject><subject>Radiosurgery - adverse effects</subject><subject>Radiosurgery - methods</subject><subject>Radiotherapy</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Tomography</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptks9rFTEQxxdRbK2evUnAi5dt83OzexFK_QkFLwreQjaZvJeymzyTbMv7783y6rMVCSTDzOf7DTNM07wm-JyQvrsgkvetJPJn27dEDk-a02Pm6YP4pHmR8w3GXDA8PG9OKOs5JYSeNuFDzIAgGz3p4mNAd75sUS6QIBZtijdojHaPkrb-AJQtJL3b13TMBbmY0BSretojbW91MGBRqFieaw4ZqNe0hA0yaym9bJ45PWV4df-eNT8-ffx-9aW9_vb569XldWsEJaW1lHcDddyJrrNaAAErKenGUY6GUgJaCCrZMHKru551hBvniO7BdphxRwU7a94ffHfLOIM1EErSk9olP-u0V1F79bgS_FZt4q1ikuI6mWrw7t4gxV8L5KJmn9dudIC4ZEU4lRgzLLqKvv0HvYlLCrW9ShGGeY8J_Utt9ATKBxfrv2Y1VZeCcUkE5yt1_h-qHguzNzGA8zX_SHBxEJgUc07gjj0SrNYVUesSqHUJVF_joSrePBzNkf-zE-w3jcm3QA</recordid><startdate>20130710</startdate><enddate>20130710</enddate><creator>Karam, Sana D</creator><creator>Horne, Zachary D</creator><creator>Hong, Robert L</creator><creator>McRae, Don</creator><creator>Duhamel, David</creator><creator>Nasr, Nadim M</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20130710</creationdate><title>Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer</title><author>Karam, Sana D ; Horne, Zachary D ; Hong, Robert L ; McRae, Don ; Duhamel, David ; Nasr, Nadim M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-d24692f4f566da5e1ed7216bb7bc221ea552739b4da683614cff1a8ed6034f253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer therapies</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Chemoradiotherapy - methods</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Fiducial Markers</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung cancer</topic><topic>Lung cancer, Non-small cell</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Radiation</topic><topic>Radiation dosimetry</topic><topic>Radiation therapy</topic><topic>Radiometry</topic><topic>Radiosurgery - adverse effects</topic><topic>Radiosurgery - methods</topic><topic>Radiotherapy</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karam, Sana D</creatorcontrib><creatorcontrib>Horne, Zachary D</creatorcontrib><creatorcontrib>Hong, Robert L</creatorcontrib><creatorcontrib>McRae, Don</creatorcontrib><creatorcontrib>Duhamel, David</creatorcontrib><creatorcontrib>Nasr, Nadim M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karam, Sana D</au><au>Horne, Zachary D</au><au>Hong, Robert L</au><au>McRae, Don</au><au>Duhamel, David</au><au>Nasr, Nadim M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer</atitle><jtitle>Radiation oncology (London, England)</jtitle><addtitle>Radiat Oncol</addtitle><date>2013-07-10</date><risdate>2013</risdate><volume>8</volume><issue>1</issue><spage>179</spage><epage>179</epage><pages>179-179</pages><artnum>179</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><abstract>Low survival outcomes have been reported for the treatment of locally advanced non small cell lung cancer (LA-NSCLC) with the standard of care treatment of concurrent chemoradiation (cCRT). We present our experience of dose escalation using stereotactic body radiosurgery (SBRT) following conventional cCRT for patients with LA-NSCLC.
Sixteen patients with a median age of 67.5 treated with fractionated SBRT from 2010 to 2012 were retrospectively analyzed. Nine (56%) of the patients had stage IIIB, 6 (38%) has stage IIIA, and 1 (6%) had recurrent disease. Majority of the patients (63%) presented with N2 disease. All patients had a PET CT for treatment planning. Patients received conventional cCRT to a median dose of 50.40 Gy (range 45-60) followed by an SBRT boost with an average dose of 25 Gy (range 20-30) given over 5 fractions.
With a median follow-up of 14 months (range, 1-14 months), 1-year overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC), and distant control (DC) rates were, 78%, 42%, 76%, 79%, and 71%, respectively. Median times to disease progression and regional failure were 10 months and 18 months, respectively. On univariate analysis, advanced age and nodal status were worse prognostic factors of PFS (p < 0.05). Four patients developed radiation pneumonitis and one developed hemoptysis. Treatment was interrupted in one patient who required hospitalization due to arrhythmias and pneumonia.
Risk adaptive dose escalation with SBRT following external beam radiotherapy is possible and generally tolerated treatment option for patients with LA-NSCLC.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>23842112</pmid><doi>10.1186/1748-717X-8-179</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Cancer therapies Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - surgery Chemoradiotherapy - methods Chemotherapy Clinical trials Disease-Free Survival Female Fiducial Markers Health aspects Humans Kaplan-Meier Estimate Lung cancer Lung cancer, Non-small cell Lung Neoplasms - mortality Lung Neoplasms - surgery Male Medical imaging Medical treatment Middle Aged NMR Nuclear magnetic resonance Patient outcomes Patients Proportional Hazards Models Radiation Radiation dosimetry Radiation therapy Radiometry Radiosurgery - adverse effects Radiosurgery - methods Radiotherapy Radiotherapy Planning, Computer-Assisted - methods Tomography |
| title | Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer |
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