119P - Feasibility and efficacy of helical IMRT for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Surgical oncology
Non-small-cell lung cancer
Therapy
Radiation oncology
Presenter Jian He
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors J. He, Z. Zeng, S. Shi
  • Department Of Radiation Oncology, Zhongshan Hospital, Fudan University, 200032 - Shanghai/CN

Abstract

Background

The aim of this study was to compare and assess the feasibility and efficacy of hypofractionated chemoradiotherapy using Helical Tomotherapy (HT) with conventional fractionation using three-dimensional conformal radiotherapy (3D-CRT) for stage III non-small-cell lung cancer (NSCLC).

Methods

Sixty-nine patients with stage III (AJCC 7th edition) NSCLC who underwent definitive radiation treatment at our institution between July 2011 and November 2013 were reviewed and analyzed retrospectively. A dose of 60 Gy in 20 fractions was delivered in the HT group (n = 34), whereas 60 Gy in 30 fractions in the 3D-CRT group (n = 35). Primary endpoints were toxicity, overall response rate, overall survival and progression-free survival.

Results

The median follow-up period was 26.4 months. V20 (P = 0.005), V30 (P = 0.001) and mean lung dose (P = 0.000) were significantly lower in the HT group than in the 3D-CRT group. The incidences of acute radiation esophagitis ≥ grade 2 was significantly lower in the HT group than in the 3D-CRT group (P = 0.027). Two year overall response rate was significantly higher in the HT group than in the 3D-CRT group. One- and 2-year overall survival (OS) rates were significantly higher in the HT group (95.0% and 68.7%, respectively) than in the 3D-CRT group (85.5% and 47.6%). One- and 2-year progression-free survival (PFS) rates were significantly higher in the HT group than in the 3D-CRT group (32.7% and 11.4%). Univariate analysis indicated that performance status (PS), T stage and radiotherapy technique were significant prognostic factors for both OS and PFS. Multivariate analysis indicated that PS and radiotherapy technique were independent prognostic factors of OS and PS was independent prognostic factor of PFS.

Conclusions

Hypofractionated chemoradiotherapy via Helical TomoTherapy can shorten the radiotherapy time without increasing treatment-related toxicity. The preliminary finding is that overall survival could be improved by hypofractionated chemoradiotherapy via Helical TomoTherapy for patients with stage III NSCLC.

Clinical trial identification

ChiCTR-OOC-15006871 (Chinese Clinical Trial Registry)

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.