Improved local control with higher doses of radiation in large-volume stage III non-small-cell lung cancer Journal Article
| Authors: | Rengan, R.; Rosenzweig, K. E.; Venkatraman, E.; Koutcher, L.; Fox, J. L.; Nayak, R.; Amols, H.; Yorke, E.; Jackson, A.; Ling, C. C.; Leibel, S. A. |
| Article Title: | Improved local control with higher doses of radiation in large-volume stage III non-small-cell lung cancer |
| Abstract: | Purpose It has been suggested that larger tumor volume is associated with poor survival in patients with non-small-cell lung cancer (NSCLC). We investigated whether high-dose radiation improved local control in patients with large-volume Stage III NSCLC. Methods and materials Seventy-two patients with Stage III NSCLC and gross tumor volumes (GTV) of greater than 100 cc were treated with three-dimensional conformal radiotherapy (3D-CRT). Patients were divided into two groups: those treated to less than 64 Gy (37 patients) and those treated to 64 Gy or higher (35 patients). Results The 1-year and 2-year local failure rates were 27% and 47%, respectively, for Stage III patients treated to 64 Gy or higher, and 61% and 76%, respectively, for those treated to less than 64 Gy (p = 0.024). The median survival time for patients treated to 64 Gy or higher was 20 months vs. 15 months for those treated to less than 64 Gy (p = 0.068). Multivariate analysis revealed that dose and GTV are predictors of local failure-free survival. A 10 Gy increase in dose resulted in a 36.4% decreased risk of local failure. Conclusions Our data suggest that administration of higher doses using 3D-CRT improves local control in Stage III NSCLC patients with large GTVs. © 2004 Elsevier Inc. |
| Keywords: | adult; cancer survival; controlled study; aged; middle aged; treatment failure; major clinical study; cisplatin; cancer radiotherapy; radiation dose; cancer staging; neoplasm staging; lung toxicity; tumor volume; lung non small cell cancer; carcinoma, non-small-cell lung; lung neoplasms; radiotherapy dosage; radiotherapy; patient monitoring; age factors; prediction; gastrointestinal toxicity; tumors; dosimetry; multivariate analysis; local control; radiotherapy, conformal; regression analysis; computer assisted radiotherapy; esophagus disease; radiation pneumonia; non-small-cell lung cancer; cells; conformal radiotherapy; dose escalation; humans; human; priority journal; article; 3d-conformal radiotherapy; gross tumor volumes (gtv) |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 60 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2004-11-01 |
| Start Page: | 741 |
| End Page: | 747 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2004.04.013 |
| PROVIDER: | scopus |
| PUBMED: | 15465190 |
| DOI/URL: | |
| Notes: | Int. J. Radiat. Oncol. Biol. Phys. -- Cited By (since 1996):82 -- Export Date: 16 June 2014 -- CODEN: IOBPD -- Source: Scopus |
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