The possible advantage of hyperfractionated thoracic radiotherapy in the treatment of locally advanced nonsmall cell lung carcinoma

Bonner, James A.; McGinnis, William L.; Stella, Phillip J.; Marschke, Robert F.; Sloan, Jeff A.; Shaw, Edward G.; Mailliard, James A.; Creagan, Edward T.; Ahuja, Rajender K.; Johnson, Patricia A.

doi:10.1002/(sici)1097-0142(19980315)82:6<1037::aid-cncr5>3.3.co;2-4

Cited by 24 publications

(29 citation statements)

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“…Data were no longer available for two NSCLC trials, 22,23 so that 10 trials were analyzed, two SCLC trials 24,25 and eight NSCLC trials. [26][27][28][29][30][31][32][33] One trial had a factorial design: patients were also randomly assigned to receive or not concomitant CT 27 ; one trial had a randomization stratified on administration of induction chemotherapy. 31 Each of these two trials were split into two separate trials, with and without chemotherapy (PMCI 88C091 and PMCI 88C091 CT; CHARTWEL and CHARTWEL CT).…”

Section: Trials and Patients Descriptionmentioning

confidence: 99%

“…In the 10 NSCLC trials, CT was administered concomitantly with RT in two trials 27,30 (carboplatin alone or cisplatin plus etoposide) and as induction chemotherapy in two trials 31,32 (according to the center practice or based on carboplatin plus paclitaxel). The NSCLC trials were divided into four categories as follows: six trials in the very accelerated RT subset, 27,28,31,32 one trial in the moderately accelerated RT subset, 33 two trials in the hyperfractionated RT with identical dose subset, 29,30 and one trial in the hyperfractionated RT with increased total dose 26 (Data Supplement).…”

Section: Trials and Patients Descriptionmentioning

confidence: 99%

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Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Mauguen

Péchoux

Saunders

et al. 2012

JCO

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216

115

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Section: Trials and Patients Descriptionmentioning

confidence: 99%

Section: Trials and Patients Descriptionmentioning

confidence: 99%

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Mauguen

Péchoux

Saunders

et al. 2012

JCO

Self Cite

216

115

View full text Add to dashboard Cite

show abstract

“…Shortening of the overall treatment time (OTT) improved local control and survival after radiotherapy of lung cancer patients (Fu et al, 1997;Bonner et al, 1998;Saunders et al, 1999), indicating the importance of cellular repopulation as a cause of failure in the radiotherapy of NSCLC (Saunders et al, 1997;Fowler and Chappell, 2000). Furthermore, tumour progression during the waiting time till the start of radiotherapy for lung cancer and head-and-neck tumours, respectively, was reported, indicating a possible negative influence on treatment results (O'Rourke and Edwards, 2000;Waaijer et al, 2003).…”

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confidence: 99%

Accelerated regrowth of non-small-cell lung tumours after induction chemotherapy

2003

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Induction chemotherapy of non-small-cell lung cancer (NSCLC) stage III with gemcitabine and cisplatin for downstaging of the tumour with the aim for further treatment with ionising radiation is one of the treatments for lung cancer patients. The purpose of this study was to investigate the influence of the waiting time for radiotherapy, that is, the interval between induction chemotherapy and radiotherapy, on the rate of tumour growth for patients with NSCLC. Interval times between the end of induction chemotherapy and date of diagnostic CT, planning CT and first day of radiotherapy were determined for 23 patients with NSCLC. Increase in gross tumour volume was measured for 18 patients by measuring the dimensions of the primary tumour and lymph node metastases on the diagnostic CT after induction chemotherapy and on the CT used for radiotherapy planning. For each patient, the volume doubling time was calculated from the time interval between the two CTs and ratio of the gross volumes on planning CT and diagnostic CT. The mean time interval between end of chemotherapy and day of diagnostic CT was 16 days, and till first day of radiotherapy 80.3 (range 29 -141) days. In all, 41% of potentially curable patients became incurable in the waiting period. The ratio of gross tumour volumes of the two CTs ranged from 1.1 to 81.8 and the tumour doubling times ranged from 8.3 to 171 days, with a mean value of 46 days and median value of 29 days. This is far less than the mean doubling time of NSCLC in untreated patients found in the literature. This study shows that in the time interval between the end of induction chemotherapy and the start of radiotherapy rapid tumour progression occurs as a result of accelerated tumour cell proliferation: mean tumour doubling times are much shorter than those in not treated tumours. As a consequence, the gain obtained with induction chemotherapy with regard to volume reduction was lost in the waiting time for radiotherapy. We recommend diminishing the time interval between chemo-and radiotherapy to as short as possible.

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“…Radiotherapy Concurrent treatment with platinum-based chemotherapy and thoracic radiotherapy (CCRT) is the current standard of care for patients with unresectable stage III NSCLC and recently the addition of durvalumab for 12 months after completion of CCRT. Randomised clinical trials favour the combination chemoradiotherapy compared with radiotherapy alone [34][35][36][37][38][39][40][41][42][43]. This is also the case for concomitant chemoradiotherapy compared with sequential chemoradiotherapy [44][45][46][47].…”

Section: Treatment Modalitiesmentioning

confidence: 99%

Interdisciplinary multimodality management of stage III nonsmall cell lung cancer

Huber¹,

Ruysscher

Hoffmann

et al. 2019

Eur Respir Rev

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Stage III nonsmall cell lung cancer (NSCLC) comprises about one-third of NSCLC patients and is very heterogeneous with varying and mostly poor prognosis. It is also called “locoregionally or locally advanced disease”. Due to its heterogeneity a general schematic management approach is not appropriate. Usually a combination of local therapy (surgery or radiotherapy, depending on functional, technical and oncological operability) with systemic platinum-based doublet chemotherapy and, recently, followed by immune therapy is used. A more aggressive approach of triple agent chemotherapy or two local therapies (surgery and radiotherapy, except for specific indications) has no benefit for overall survival. Until now tumour stage and the general condition of the patient are the most relevant prognostic factors. Characterising the tumour molecularly and immunologically may lead to a more personalised and effective approach. At the moment, after an exact staging and functional evaluation, an interdisciplinary discussion amongst the tumour board is warranted and offers the best management strategy.

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The possible advantage of hyperfractionated thoracic radiotherapy in the treatment of locally advanced nonsmall cell lung carcinoma

Cited by 24 publications

References 0 publications

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Accelerated regrowth of non-small-cell lung tumours after induction chemotherapy

Interdisciplinary multimodality management of stage III nonsmall cell lung cancer

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