Treatment-Related Pneumonitis and Acute Esophagitis in Non-Small-Cell Lung Cancer Patients Treated With Chemotherapy and Helical Tomotherapy

Journal Article · Mon Nov 01 00:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.08.068· OSTI ID:21437991

Song, Chang Hoon ^[1]; Pyo, Hongryull ^[2]; Moon, Sung Ho; Kim, Tae Hyun; Kim, Dae Woong; Cho, Kwan Ho ^[2]

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1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of)
2. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of)

Purpose: To assess clinical outcomes and complications in patients with non-small-cell lung cancer (NSCLC) treated with helical tomotherapy (HT) with or without chemotherapy. Methods and Materials: Data from 37 NSCLC patients treated between January 2007 and August 2008 were analyzed retrospectively. Twenty-eight patients had Stage III disease. Concurrent and neoadjuvant chemotherapy was given to 24 and 14 patients, respectively. Radiotherapy was delivered to a total dose of 60-70.4 Gy at 2.0-2.4 Gy per fraction to the gross tumor volume and 50-64 Gy at 1.8-2.0 Gy per fraction to the planning target volume. Results: With a median follow-up of 18 months (range, 6-27 months), 2-year local control and overall survival rates were 63% and 56% for all 37 patients, respectively, and were 78% and 75% for the patients with Stage III disease who received concurrent chemoradiotherapy alone. Acute esophagitis and treatment-related pneumonitis (TRP) {>=}Grade 3 occurred in 5 and 7 patients, respectively. Four patients died of treatment-related death (TRD) after HT. In univariate analysis, poor performance status, total lung V{sub 5}, contralateral lung (CL) V{sub 5}, and V{sub 10} were associated with TRD. Only CL V{sub 5} remained significant in the multivariate analysis (p = 0.029). Conclusions: HT with chemotherapy has shown promising clinical outcomes, esophagitis, and TRPs. However, HT has produced a somewhat high rate of fatal pulmonary complications. Our data suggest that CL V{sub 5} should be considered and kept as low as possible (<60%) in addition to the conventional dosimetric factors.

• OSTI ID: 21437991
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 78, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2009.08.068; PII: S0360-3016(09)03047-8; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
COMBINED THERAPY
COMPUTERIZED TOMOGRAPHY
CT-GUIDED RADIOTHERAPY
ESOPHAGUS
INFLAMMATION
LUNGS
NEOPLASMS
PNEUMONITIS
TOXICITY
BODY
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SYMPTOMS
THERAPY
TOMOGRAPHY