Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T1–3N0 non–small-cell lung cancer: Is low incidence of regional failure due to incidental nodal irradiation?

Chen, Ming; Hayman, James A.; Haken, Randall K. Ten; Tatro, Daniel; Fernando, Shaneli; Kong, Feng-Ming

doi:10.1016/j.ijrobp.2005.06.029

Cited by 73 publications

(32 citation statements)

References 40 publications

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“…25 Similarly, in non small cell lung cancer (NSCLC) treatment, many authors suggest that unintentional irradiation of the clinically non-affected mediastinum generally provides satisfactory control of subclinical disease, with average doses lower than 40 Gy and with less local toxicity. 26,27 However, patients with malignant neoplasms of the lung have a high rate of local failure and reduced survival, which can underreport a nodal failure.…”

Section: Discussionmentioning

confidence: 99%

Unintended irradiation of internal mammary chain – Is that enough?

Sapienza

Chen

Gomes

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Section: Discussionmentioning

confidence: 99%

Unintended irradiation of internal mammary chain – Is that enough?

Sapienza

Chen

Gomes

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…Prospective 3DCRT studies from the University of Michigan and the Radiation Therapy Oncology Group, which were not specific to stage I disease, explored an approach of dose escalation by increasing the number of radiation treatment sessions. 9,10 Although high doses ranging from 83.4 to 102.9 Gy were feasible when the volume of irradiated lung was limited, overall treatment time was extended to between 8 and 10 weeks. Using the favorable dose distribution of 3DCRT, we hypothesized that it would be possible to deliver larger single daily fractions resulting in an acceleration of the radiotherapy course.…”

Section: Introductionmentioning

confidence: 99%

Phase I Study of Accelerated Conformal Radiotherapy for Stage I Non–Small-Cell Lung Cancer in Patients With Pulmonary Dysfunction: CALGB 39904

Bogart

Hodgson

Seagren

et al. 2010

JCO

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Purpose The optimal treatment for medically inoperable stage I non–small-cell lung cancer (NSCLC) has not been defined. Patients and Methods Cancer and Leukemia Group B trial 39904 prospectively assessed accelerated, once-daily, three-dimensional radiotherapy for early-stage NSCLC. The primary objectives were to define the maximally accelerated course of conformal radiotherapy and to describe the short-term and long-term toxicity of therapy. Entry was limited to patients with clinical stage T1N0 or T2N0 NSCLC (< 4 cm) and pulmonary dysfunction. The nominal total radiotherapy dose remained at 70 Gy, while the number of daily fractions in each successive cohort was reduced. Results Thirty-nine eligible patients were accrued (eight patients each on cohorts 1 to 4 and seven patients on cohort 5) between January 2001 and July 2005. One grade 3 nonhematologic toxicity was observed in both cohort 3 (dyspnea) and cohort 4 (pain). The major response rate was 77%. After a median follow-up time of 53 months, the actuarial median survival time of all eligible patients was 38.5 months. Local relapse was observed in three patients. Conclusion Accelerated conformal radiotherapy was well tolerated in a high-risk population with clinical stage I NSCLC. Outcomes are comparable to prospective reports of alternative therapies, including stereotactic body radiation therapy and limited resection, with less apparent severe toxicity. Further investigation of this approach is warranted.

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“…It may be that incidental irradiation to clinically uninvolved nodal regions may help to explain the low incidence of ENF. Chen et al reported the results of IF-RT using 3D-CRT technique and examined incidental irradiation and ENF in thirty-five patients with inoperable early-stage NSCLC (T1-3N0M0) 21) . Although the incidental irradiation to regional nodal stations was low (fewer than 10% of all nodal regions received a dose of >40Gy), ENF was observed in only two patients who developed nodal relapse after local progression, and no patients failed initially at nodal sites.…”

Section: Incidental Irradiation Of If-rtmentioning

confidence: 99%

Involved-Field Radiation Therapy (IF-RT) for Non-Small Cell Lung Cancer (NSCLC)

Kimura¹

2012

Modern Practices in Radiation Therapy

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Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T1–3N0 non–small-cell lung cancer: Is low incidence of regional failure due to incidental nodal irradiation?

Cited by 73 publications

References 40 publications

Unintended irradiation of internal mammary chain – Is that enough?

Unintended irradiation of internal mammary chain – Is that enough?

Phase I Study of Accelerated Conformal Radiotherapy for Stage I Non–Small-Cell Lung Cancer in Patients With Pulmonary Dysfunction: CALGB 39904

Involved-Field Radiation Therapy (IF-RT) for Non-Small Cell Lung Cancer (NSCLC)

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