TY - JOUR
T1 - Improved local control with higher doses of radiation in large-volume stage III non-small-cell lung cancer
AU - Rengan, Ramesh
AU - Rosenzweig, Kenneth E.
AU - Venkatraman, Ennapadam
AU - Koutcher, Lawrence A.
AU - Fox, Jana L.
AU - Nayak, Reena
AU - Amols, Howard
AU - Yorke, Ellen
AU - Jackson, Andrew
AU - Ling, C. Clifton
AU - Leibel, Steven A.
N1 - Funding Information:
Supported in part by grant #PO1-CA-59017 from the National Cancer Institute, National Institutes of Health.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2004/11/1
Y1 - 2004/11/1
N2 - 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.
AB - 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.
KW - 3D-Conformal radiotherapy
KW - Dose escalation
KW - Local control
KW - Non-small-cell lung cancer
KW - Tumor volume
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U2 - 10.1016/j.ijrobp.2004.04.013
DO - 10.1016/j.ijrobp.2004.04.013
M3 - Article
C2 - 15465190
AN - SCOPUS:4744341224
SN - 0360-3016
VL - 60
SP - 741
EP - 747
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -
