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Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904.

Publication ,  Journal Article
Bogart, JA; Hodgson, L; Seagren, SL; Blackstock, AW; Wang, X; Lenox, R; Turrisi, AT; Reilly, J; Gajra, A; Vokes, EE; Green, MR
Published in: J Clin Oncol
January 10, 2010

PURPOSE: The optimal treatment for medically inoperable stage I non-small-cell lung cancer (NSCLC) has not been defined. PATIENTS AND METHODS: Cancer and Leukemia Group B trial 39904 prospectively assessed accelerated, once-daily, three-dimensional radiotherapy for early-stage NSCLC. The primary objectives were to define the maximally accelerated course of conformal radiotherapy and to describe the short-term and long-term toxicity of therapy. Entry was limited to patients with clinical stage T1N0 or T2N0 NSCLC (< 4 cm) and pulmonary dysfunction. The nominal total radiotherapy dose remained at 70 Gy, while the number of daily fractions in each successive cohort was reduced. RESULTS: Thirty-nine eligible patients were accrued (eight patients each on cohorts 1 to 4 and seven patients on cohort 5) between January 2001 and July 2005. One grade 3 nonhematologic toxicity was observed in both cohort 3 (dyspnea) and cohort 4 (pain). The major response rate was 77%. After a median follow-up time of 53 months, the actuarial median survival time of all eligible patients was 38.5 months. Local relapse was observed in three patients. CONCLUSION: Accelerated conformal radiotherapy was well tolerated in a high-risk population with clinical stage I NSCLC. Outcomes are comparable to prospective reports of alternative therapies, including stereotactic body radiation therapy and limited resection, with less apparent severe toxicity. Further investigation of this approach is warranted.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

January 10, 2010

Volume

28

Issue

2

Start / End Page

202 / 206

Location

United States

Related Subject Headings

  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Lung Diseases
  • Humans
  • Female
  • Disease-Free Survival
 

Citation

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Bogart, J. A., Hodgson, L., Seagren, S. L., Blackstock, A. W., Wang, X., Lenox, R., … Green, M. R. (2010). Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904. J Clin Oncol, 28(2), 202–206. https://doi.org/10.1200/JCO.2009.25.0753
Bogart, Jeffrey A., Lydia Hodgson, Stephen L. Seagren, A William Blackstock, Xiaofei Wang, Robert Lenox, Andrew T. Turrisi, et al. “Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904.J Clin Oncol 28, no. 2 (January 10, 2010): 202–6. https://doi.org/10.1200/JCO.2009.25.0753.
Bogart JA, Hodgson L, Seagren SL, Blackstock AW, Wang X, Lenox R, et al. Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904. J Clin Oncol. 2010 Jan 10;28(2):202–6.
Bogart, Jeffrey A., et al. “Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904.J Clin Oncol, vol. 28, no. 2, Jan. 2010, pp. 202–06. Pubmed, doi:10.1200/JCO.2009.25.0753.
Bogart JA, Hodgson L, Seagren SL, Blackstock AW, Wang X, Lenox R, Turrisi AT, Reilly J, Gajra A, Vokes EE, Green MR. Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904. J Clin Oncol. 2010 Jan 10;28(2):202–206.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

January 10, 2010

Volume

28

Issue

2

Start / End Page

202 / 206

Location

United States

Related Subject Headings

  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Lung Diseases
  • Humans
  • Female
  • Disease-Free Survival