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Phase I study of hypofractionated dose-escalated thoracic radiotherapy for limited-stage small-cell lung cancer

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1];  [2];  [3];  [1];  [4];  [4];  [4];  [1]
  1. Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada)
  2. Department of Radiation Oncology, Centre for the Southern Interior, Kelowna, British Columbia (Canada)
  3. Department of Preventive Oncology and Epidemiology, Cross Cancer Institute, Edmonton, Alberta (Canada)
  4. Department of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada)
Purpose: To determine the maximal tolerated dose of hypofractionated thoracic radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer patients. Methods and Materials: Three radiotherapy regimens were used. Radiotherapy was given in two phases: patients initially received 20 Gy in 10 fractions to gross tumor plus uninvolved mediastinal nodes, followed by a boost to gross disease of 30, 38, or 42 Gy in 15 fractions. Radiotherapy was planned with conformal techniques. All patients received four cycles of cisplatin (25 mg/m{sup 2}) and etoposide (100 mg/m{sup 2}) chemotherapy. Radiotherapy commenced with Day 1 of Cycle 2 of chemotherapy. All complete/near-complete responders were offered prophylactic cranial irradiation. The maximal tolerated dose of radiotherapy was based on the dose that caused unacceptably high rates of radiotherapy-related toxicity. Results: Thirteen patients were accrued. All patients who commenced radiotherapy received all prescribed chemo- and radiotherapy. There were no treatment-related deaths. There was one Grade 3 acute nonhematologic toxicity in the 50-Gy group. Of the 6 patients given 58 Gy, 3 experienced acute Grade 3 esophagitis. With a median follow-up of 7 months, median overall survival was 9.5 months. Conclusions: The maximal tolerated dose of thoracic radiotherapy with concurrent chemotherapy on this trial was 50 Gy in 25 daily fractions.
OSTI ID:
20793506
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
Country of Publication:
United States
Language:
English

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