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73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer.

Publication ,  Journal Article
Maguire, PD; Marks, LB; Sibley, GS; Herndon, JE; Clough, RW; Light, KL; Hernando, ML; Antoine, PA; Anscher, MS
Published in: J Clin Oncol
February 1, 2001

PURPOSE: To assess results with twice-daily high-dose radiotherapy (RT) for non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Between 1991 and 1998, 94 patients with unresectable NSCLC were prescribed > or = 73.6 Gy via accelerated fractionation. Fifty were on a phase II protocol (P group); 44 were similarly treated off-protocol (NP group). The clinical target volume received 45 Gy at 1.25 Gy bid (6-hour interval). The gross target volume received 1.6 Gy bid to 73.6 to 80 Gy over 4.5 to 5 weeks using a concurrent boost technique. Overall survival (OS) and local progression-free survival (LPFS) were calculated by the Kaplan-Meier method. Median follow-up durations for surviving P and NP patients were 67 and 16 months, respectively. RESULTS: Total doses received were > or = 72 Gy in 97% of patients. The median OS by stage was 34, 13, and 12 months for stages I/II, IIIa, and IIIb, respectively. LPFS was significantly longer for patients with T1 lesions (median, 43 months) versus T2-4 (median, 7 to 10 months; P =.01). Results were similar in the P and NP groups. Acute grade > or = 3 toxicity included esophagus (14 patients; 15%), lung (three patients; 3% [one grade 5]), and skin (four patients; 4%). Grade > or = 3 late toxicity in 86 assessable patients included esophagus (three patients; 3%), lung (15 patients; 17% [three grade 5]), skin (five patients; 6%), heart (two patients; 2%), and nerve (one patient; 1%). CONCLUSION: This regimen yielded favorable survival results, particularly for T1 lesions. Acute grade > or = 3 toxicity seems greater than for conventional RT, though most patients recovered. Late grade > or = 3 pulmonary toxicity occurred in 17%. Because of continued locoregional recurrences, we are currently using doses > or = 86 Gy.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

February 1, 2001

Volume

19

Issue

3

Start / End Page

705 / 711

Location

United States

Related Subject Headings

  • Survival Analysis
  • Radiotherapy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Dose-Response Relationship, Radiation
 

Citation

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Maguire, P. D., Marks, L. B., Sibley, G. S., Herndon, J. E., Clough, R. W., Light, K. L., … Anscher, M. S. (2001). 73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer. J Clin Oncol, 19(3), 705–711. https://doi.org/10.1200/JCO.2001.19.3.705
Maguire, P. D., L. B. Marks, G. S. Sibley, J. E. Herndon, R. W. Clough, K. L. Light, M. L. Hernando, P. A. Antoine, and M. S. Anscher. “73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer.J Clin Oncol 19, no. 3 (February 1, 2001): 705–11. https://doi.org/10.1200/JCO.2001.19.3.705.
Maguire PD, Marks LB, Sibley GS, Herndon JE, Clough RW, Light KL, et al. 73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer. J Clin Oncol. 2001 Feb 1;19(3):705–11.
Maguire, P. D., et al. “73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer.J Clin Oncol, vol. 19, no. 3, Feb. 2001, pp. 705–11. Pubmed, doi:10.1200/JCO.2001.19.3.705.
Maguire PD, Marks LB, Sibley GS, Herndon JE, Clough RW, Light KL, Hernando ML, Antoine PA, Anscher MS. 73.6 Gy and beyond: hyperfractionated, accelerated radiotherapy for non-small-cell lung cancer. J Clin Oncol. 2001 Feb 1;19(3):705–711.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

February 1, 2001

Volume

19

Issue

3

Start / End Page

705 / 711

Location

United States

Related Subject Headings

  • Survival Analysis
  • Radiotherapy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Dose-Response Relationship, Radiation