Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer

Radiation Oncology

Nadim M Nasr³  David Duhamel¹  Don McRae³  Robert L Hong³  Zachary D Horne²  Sana D Karam² 

[1] Department of Pulmonary/Critical Care Medicine, Virginia Hospital Center, Arlington, VA, USA;Department of Radiation Oncology, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, USA;Department of Radiation Oncology, Virginia Hospital Center, Arlington, VA, USA

关键词: Age;    Nodal;    Stage IIIB;    Stage IIIA;    Locally advanced;    Dose escalation;    Boost;    Cyberknife;    SABR;    SBRT;   

Others  :  1153425
DOI  :  10.1186/1748-717X-8-179

 received in 2013-04-30, accepted in 2013-06-28,  发布年份 2013

【 摘 要 】

Introduction

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.

Methods

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.

Results

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.

Conclusion

Risk adaptive dose escalation with SBRT following external beam radiotherapy is possible and generally tolerated treatment option for patients with LA-NSCLC.

【 授权许可】

   
2013 Karam et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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