High Dose Conformal Radiotherapy in Stage III Non-Small Cell Lung Cancer: A Feasibility Study
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- Category: Vol. 82, March 2014
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High Dose Conformal Radiotherapy in Stage III Non-Small Cell Lung Cancer: A Feasibility Study, GHADA E. ELADAWEI and RAED ELMETWALLY
Abstract
Purpose: The aim of the study is to evaluate safety and efficacy of high dose 3-D conformal radiotherapy to the involved field for patients with stage III non-small cell lung cancer.
Patients and Methods: 21 patients; 17 males and 4 females with median age 60 years (range; 42-68 years) with stage IIIA/IIIB NSCLC were treated by induction chemotherapy with four cycles of cisplatin and gemcitabine at doses of 70mg/m2 on day 1 and 1250mg/m2 on day 1 and 8, respec-tively, and three dimensional conformal radiotherapy in conventional fractionation 2 Gy/fraction, 5 fraction/week to a total dose of 70-74 Gy.
Results: The treatment was well tolerated with insignificant difference in pulmonary function tests before and after radiation therapy. No patients within the entire group had treatment related death (Grade IV). The acute common radiation-related toxicities included radiation esophagitis and pneumonitis, but most of these toxicities were mild to moderate and could be easily treated with supportive management. There were 2 patients (9.5%) with grade III pneumonitis and also 2 patients (9.5%) developed grade III esophagitis. High dose 3DCRT achieved a favorable efficacy. The total response (CR+PR) rate was 75.2%. Three patients (14.3%) had stable disease and 2 patients (9.5%) expressed progressive disease. The median PFS was 12 months (95% CI 9.487-14.513) and the median OS was 18 months (95% CI 12.921-23.079).
Conclusion: High dose of 70-74 Gy 3D conformal radio-therapy was well tolerated and may improve overall survival rate for patients with stage III non-small cell lung cancer.