Author of

• 11645

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  P2.08 - Poster Session 2 - Radiotherapy (ID 198)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Radiation Oncology + Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11648

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    P2.08-003 - Involved-Field Radiotherapy versus Elective Nodal Irradiation in Combination with Concurrent Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer: A Prospective Randomized Study (ID 311)

    09:30 - 09:30  |  Author(s): F. Peng
    • Abstract

    Background
    Whether IFRT could replace ENI or not has been a controversial topic for years because of rare data from large sample sizes, prospective, randomized studies were available. This study is to evaluate the locoregional failure and its impact on survival by prospectively comparing involved field radiotherapy (IFRT) with elective nodal irradiation (ENI) for locally advanced non-small cell lung cancer with concurrent chemoradiotherapy.

    Methods
    Patients were randomized into IFRT or ENI arm，treated with 2 cycles of carboplatin combined with paclitaxel. Those without distant metastasis continued to receive chemoradiotherapy. The target volumes for IFRT included primary tumor, ipsilateral hilum and positive mediastinal lymph nodes, while that for ENI included the primary lesion, ipsilateral hilum, bilateral mediastinal lymph node drainage areas and bilateral supraclavicular fossa. The radiation dose was prescribed as high as possible if the restrictions could be met: percent volume of bilateral lung receiving ≥ 20Gy (V20) was ≤35% and the maximum dose to spinal cord was ≤50Gy.

    Results
    99 consecutive patients were assigned (45 IFRT vs. 54 ENI), with more patients in IFRT iiradiated with ＞60Gy than those in ENI (48.9% vs. 25.9%, P=0.018). the local failure rates were 34.1% and 30.0%（P=0.673）, Of which the isolated ENF was 0.0% and 2.0%, respectively (P=0.363). The median survival time was 27.8 months (95% CI, 18.0-37.5 months) and 16.7 months (95% CI, 15.0-18.4 months); the 1-, 2- and 3-year local tumor progression-free survival rates were 78.1%、72.6%、62.9% and 85.5%、61.2%、56.1% （P=0.895）, respectively; the 1-, 2- and 3-year overall survival rates were 80.0%、53.3%、36.6% and 70.4%、34.9%、30.3% （P=0.08）, respectively.

    Conclusion
    Preliminary results indicated that IFRT did not increase locoregional failure related to ENF. With IFRT, higher radiation dose could be administered compared with ENI and it is expected to improve survival. Further investigation is warranted.