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Conference Paper: 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?

TitleLong-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?
Authors
KeywordsMedically inoperable
Non-small-cell lung cancer
Incidental nodal irradiation
Issue Date2006
Citation
International Journal of Radiation Oncology Biology Physics, 2006, v. 64, n. 1, p. 120-126 How to Cite?
AbstractPurpose: To report the results of high-dose conformal irradiation and examine incidental nodal irradiation and nodal failure in patients with inoperable early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: This analysis included patients with inoperable CT-staged T1-3N0M0 NSCLC treated on our prospective dose-escalation trial. Patients were treated with radiation alone (total dose, 63-102.9 Gy in 2.1-Gy daily fractions) with a three-dimensional conformal technique without intentional nodal irradiation. Bilateral highest mediastinal and upper/lower paratracheal, prevascular and retrotracheal, sub- and para-aortic, subcarinal, paraesophageal, and ipsilateral hilar regions were delineated individually. Nodal failure and doses of incidental irradiation were studied. Results: The potential median follow-up was 104 months. For patients who completed protocol treatment, median survival was 31 months. The actuarial overall survival rate was 86%, 61%, 43%, and 21% and the cause-specific survival rate was 89%, 70%, 53%, and 35% at 1, 2, 3, and 5 years, respectively. Weight loss (p = 0.008) and radiation dose in Gy (p = 0.013) were significantly associated with overall survival. In only 22% and 13% of patients examined did ipsilateral hilar and paratracheal (and subaortic for left-sided tumor) nodal regions receive a dose of <40 Gy, respectively. Less than 10% of all other nodal regions received a dose of <40 Gy. No patients failed initially at nodal sites. Conclusions: Radiation dose is positively associated with overall survival in patients with medically inoperable T1-3N0 NSCLC, though long-term results remain poor. The nodal failure rate is low and does not seem to be due to high-dose incidental irradiation. © 2006 Elsevier Inc.
Persistent Identifierhttp://hdl.handle.net/10722/266848
ISSN
2023 Impact Factor: 6.4
2023 SCImago Journal Rankings: 1.992
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChen, Ming-
dc.contributor.authorHayman, James A.-
dc.contributor.authorTen Haken, Randall K.-
dc.contributor.authorTatro, Daniel-
dc.contributor.authorFernando, Shaneli-
dc.contributor.authorKong, Feng Ming-
dc.date.accessioned2019-01-31T07:19:47Z-
dc.date.available2019-01-31T07:19:47Z-
dc.date.issued2006-
dc.identifier.citationInternational Journal of Radiation Oncology Biology Physics, 2006, v. 64, n. 1, p. 120-126-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/266848-
dc.description.abstractPurpose: To report the results of high-dose conformal irradiation and examine incidental nodal irradiation and nodal failure in patients with inoperable early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: This analysis included patients with inoperable CT-staged T1-3N0M0 NSCLC treated on our prospective dose-escalation trial. Patients were treated with radiation alone (total dose, 63-102.9 Gy in 2.1-Gy daily fractions) with a three-dimensional conformal technique without intentional nodal irradiation. Bilateral highest mediastinal and upper/lower paratracheal, prevascular and retrotracheal, sub- and para-aortic, subcarinal, paraesophageal, and ipsilateral hilar regions were delineated individually. Nodal failure and doses of incidental irradiation were studied. Results: The potential median follow-up was 104 months. For patients who completed protocol treatment, median survival was 31 months. The actuarial overall survival rate was 86%, 61%, 43%, and 21% and the cause-specific survival rate was 89%, 70%, 53%, and 35% at 1, 2, 3, and 5 years, respectively. Weight loss (p = 0.008) and radiation dose in Gy (p = 0.013) were significantly associated with overall survival. In only 22% and 13% of patients examined did ipsilateral hilar and paratracheal (and subaortic for left-sided tumor) nodal regions receive a dose of <40 Gy, respectively. Less than 10% of all other nodal regions received a dose of <40 Gy. No patients failed initially at nodal sites. Conclusions: Radiation dose is positively associated with overall survival in patients with medically inoperable T1-3N0 NSCLC, though long-term results remain poor. The nodal failure rate is low and does not seem to be due to high-dose incidental irradiation. © 2006 Elsevier Inc.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Radiation Oncology Biology Physics-
dc.subjectMedically inoperable-
dc.subjectNon-small-cell lung cancer-
dc.subjectIncidental nodal irradiation-
dc.titleLong-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?-
dc.typeConference_Paper-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2005.06.029-
dc.identifier.pmid16198503-
dc.identifier.scopuseid_2-s2.0-29244436358-
dc.identifier.volume64-
dc.identifier.issue1-
dc.identifier.spage120-
dc.identifier.epage126-
dc.identifier.isiWOS:000234442200018-
dc.identifier.issnl0360-3016-

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