Author of

• 25439

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  Limitations and advances of thoracic radiotherapy (ID 58)

  • Event: ELCC 2018
  • Type: Proffered Paper session
  • Track:
  • Presentations: 1
  • Moderators:C. Le Pechoux, S. Senan
  • Coordinates: 4/12/2018, 15:00 - 16:00, Room B

  • 25440

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    110O - High-dose radiation therapy based on normal tissue constraints with concurrent chemotherapy improves survival of patients with unresectable stage III non-small cell lung cancer (ID 326)

    15:00 - 15:15  |  Author(s): M. Liu
    • Abstract

    Background:
    RTOG0617 found higher radiation dose does not benefit patients with unresectable stage III non-small cell lung cancer (NSCLC). To investigate the potential benefit of individual isotoxic dose escalation based on normal tissue constraints (NTC), hypothesizing that high-dose radiation therapy would be superior to standard-dose in concurrent chemoradiotherapy for unresectable stage III NSCLC.
    
    Methods:
    Data from two prospective clinical trials were merged for analysis. Individually prescribed radiation doses were calculated based on NTC. Patients with total radiation doses ≥66 Gy were assigned to the high-dose group (H-D, ≥66 Gy), and all other patients were assigned to the standard-dose group (S-D, <66 Gy). Intensity modulated radiation therapy plans were optimized to minimize the volumes of organs at risk exposed to radiation. The primary endpoint was overall survival.
    
    Results:
    From March 2006 to September 2012, 140 patients were enrolled and assigned to one of two groups: 71 patients into the H-D group and 69 patients into the S-D group. The median survival time (MST) was significantly higher in the H-D group (33.5 months) than in the S-D group (17 months), (p < 0.0001). Overall 5-year survival rates were significantly higher in the H-D group than in the S-D group (38.0% vs. 12.3%). Median progression-free survival was 19 months in the H-D group and 11 months in the S-D group (p < 0.0001). No difference in severe (grade 3–5) toxic effects was noted between the two groups.
    
    Conclusions:
    The dose-escalated radiation concurrent with chemotherapy showed an significant advantage in MST and survival rates over standard-dose. This individualized isotoxic dose chemoradiotherapy strategy may be a promising method for unresectable stage III NSCLC patients.
    
    Clinical trial identification:
    
    
    Legal entity responsible for the study:
    Shandong Cancer Hospital
    
    Funding:
    This study was supported in part by National Nature Science Foundation of China (Grant NO. 81530060), and The National Key Research and Development Plan (Grant NO. 2016YFC0105106).
    
    Disclosure:
    All authors have declared no conflicts of interest.