A Phase I/II Study of Chemotherapy Concurrent with Twice-daily Radiotherapy Schedules by Intensity Modulated Radiation Therapy Using Simultaneous Integrated Boost for Limited-stage Small Cell Lung Cancer
10.3779/j.issn.1009-3419.2017.01.04
- VernacularTitle:局限期小细胞肺癌同步推量调强放疗的I期/II期临床研究
- Author:
YOU JING
1
;
YU HUIMING
;
SONG MAXIAOWEI
;
SHI CHEN
;
WANG XIAOHANG
;
ZHENG YE
;
YU RONG
;
SHI ANHUI
;
ZHU GUANGYING
Author Information
1. 100142北京，北京大学肿瘤医院暨北京市肿瘤防治研究所，恶性肿瘤发病机制及转化研究教育部重点实验室，放疗科
- Keywords:
Lung neoplasms;
Concurrent chemo-radiotherapy;
Simultaneous integrated boost
- From:
Chinese Journal of Lung Cancer
2017;20(1):28-34
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Twice-daily radiation concurrent with chemotherapy is one of the standard methods for limited-stage small cell lung cancer. hTe study was to evaluate the feasibility of chemotherapy concurrent with dose-escalating twice-daily radiotherapy by simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) approach in patients with limited-stage small cell lung cancer. Methods Patients with limited-stage small cell lung cancer were included, treated with twice-daily radiotherapy by SIB-IMRT concurrent with chemotherapy of etoposide plus cisplatin. Dose escalation was conducted by“classical”3+3 methods with three patients enrolled in each dose level. The therapeutic gross tumor volume (GTV) was treated according to three consecutive dose levels i.e., 45 Gy at 1.5 Gy twice daily, 50 Gy at 1.67 Gy twice daily and 54 Gy at 1.8 Gy twice daily. hTe planning target volume (PTV) received a dose of 45 Gy delivered in 30 fractions of 1.5 Gy. hTe primary endpoints were acute toxicities. hTe secondary endpoints included overall survival (OS), pro-gression-free survival (PFS) and loco-regional failure-free survival (LRFFS) at 1-year of follow-up. Results Twenty men and six women were included. hTe median age was 52 (30-68) months. 12 patients experienced grade 2 acute esophagitis, and 1 patient developed grade 3 acute esophagitis. Only 3 patients developed Grade 2 pneumonitis. Grade 3 or higher radiation-related pneumonia was not observed. None died of treatment-related causes. With median follow-up of 11.2 months (3.2-36.2 months), 1-year OS, PFS and LRFFS were 89.0%, 51.0%and 85.0%, respectively. Conclusion Dose escalation for twice-daily radiation concurrent with chemotherapy in LS-SCLC has been safely achieved up to 54 Gy for GTV using SIB-IMRT technique.
