Primary Analysis of a Phase II Randomized Trial Radiation Therapy Oncology Group (RTOG) 0212: Impact of Different Total Doses and Schedules of Prophylactic Cranial Irradiation on Chronic Neurotoxicity and Quality of Life for Patients With Limited-Disease Small-Cell Lung Cancer

Journal Article · Thu Sep 01 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.05.013· OSTI ID:21587687

Bae, Kyounghwa ^[1]; Komaki, Ritsuko; Meyers, Christina ^[2]; Movsas, Benjamin ^[3]; Le Pechoux, Cecile ^[4]; Werner-Wasik, Maria ^[5]; Videtic, Gregory M.M. ^[6]; Garces, Yolanda I ^[7]; Choy, Hak ^[8]

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1. Department of Statistics, Radiation Therapy Oncology Group, Philadelphia, PA (United States)
2. M. D. Anderson Cancer Center, Houston, TX (United States)
3. Henry Ford Health System, Detroit, MI (United States)
4. Institute Gustave Roussy, Villejuif (France)
5. Thomas Jefferson Medical College, Philadelphia, PA (United States)
6. Cleveland Clinic, Cleveland, OH (United States)
7. Mayo Clinic, Rochester, MN (United States)
8. University of Texas Southwestern, Dallas, TX (United States)

Purpose: To determine the effect of dose and fractionation schedule of prophylactic cranial irradiation (PCI) on the incidence of chronic neurotoxicity (CNt) and changes in quality of life for selected patients with limited-disease small-cell lung cancer (LD SCLC). Methods and Materials: Patients with LD SCLC who achieved a complete response after chemotherapy and thoracic irradiation were eligible for randomization to undergo PCI to a total dose of 25 Gy in 10 daily fractions (Arm 1) vs. the experimental cohort of 36 Gy. Those receiving 36 Gy underwent a secondary randomization between daily 18 fractions (Arm 2) and twice-daily 24 fractions (Arm 3). Enrolled patients participated in baseline and follow-up neuropsychological test batteries along with quality-of-life assessments. Results: A total of 265 patients were accrued, with 131 in Arm 1, 67 in Arm 2, and 66 in Arm 3 being eligible. There are 112 patients (42.2%) alive with 25.3 months of median follow-up. There were no significant baseline differences among groups regarding quality-of-life measures and one of the neuropsychological tests, namely the Hopkins Verbal Learning Test. However, at 12 months after PCI there was a significant increase in the occurrence of CNt in the 36-Gy cohort (p = 0.02). Logistic regression analysis revealed increasing age to be the most significant predictor of CNt (p = 0.005). Conclusions: Because of the increased risk of developing CNt in study patients with 36 Gy, a total PCI dose of 25 Gy remains the standard of care for patients with LD SCLC attaining a complete response to initial chemoradiation.

• OSTI ID: 21587687
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CHEMOTHERAPY
DISEASES
DOSES
HAZARDS
IRRADIATION
LUNGS
MATHEMATICS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
REGRESSION ANALYSIS
RESPIRATORY SYSTEM
SCHEDULES
STANDARD OF LIVING
STATISTICS
THERAPY