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Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer.

Publication ,  Journal Article
Miller, KL; Marks, LB; Sibley, GS; Clough, RW; Garst, JL; Crawford, J; Shafman, TD
Published in: Int J Radiat Oncol Biol Phys
June 1, 2003

PURPOSE: To review the outcome of patients with limited-stage small-cell lung cancer receiving daily thoracic irradiation (RT) to approximately 60 Gy. METHODS AND MATERIALS: The records of patients treated with RT for limited-stage small-cell lung cancer between 1991 and 1999 at Duke University were retrospectively reviewed. Sixty-five patients were identified who had received continuous course once-daily 1.8-2 Gy fractions to approximately 60 Gy (range 58-66). All patients received chemotherapy (CHT); 32 received concurrent RT/CHT and 33 sequential CHT and then RT. Prophylactic cranial RT was administered to 17 patients. The time from diagnosis to local failure, tumor progression, and death was assessed using actuarial methods. The median follow-up for all patients was 16.7 months and for surviving patients was 29.6 months. The median age was 64 years (range 36-83), and the median Karnofsky performance status was 80 (range 50-100). RESULTS: The 3-year actuarial rate of local failure, progression-free survival, and overall survival was 40%, 25%, and 23%, respectively. One case of acute Grade 3 esophagitis developed. Ten late complications occurred: four pulmonary, two esophageal, two infectious, one leukemia, and one retinal toxicity with prophylactic cranial RT. Six were mild and resolved with treatment. CONCLUSION: CHT plus approximately 60 Gy of once-daily RT for limited-stage small-cell lung cancer was generally well tolerated. The survival rates were less than have been reported using 45 Gy in 1.5-Gy twice-daily fractions (2-year overall survival rate 47% compared with 30% in this study), but may be comparable because fewer than one-half our patients received concurrent CHT/RT and only 26% received prophylactic cranial RT. The relatively low rate of normal tissue morbidity in our patients supports the use of conventional once-daily fractionation to > or = 60 Gy. A randomized trial would be required to compare the outcomes after maximally tolerated dose twice-daily RT vs. maximally tolerated dose daily RT.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

June 1, 2003

Volume

56

Issue

2

Start / End Page

355 / 359

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Radiotherapy Dosage
  • Radiotherapy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lung Neoplasms
 

Citation

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Miller, K. L., Marks, L. B., Sibley, G. S., Clough, R. W., Garst, J. L., Crawford, J., & Shafman, T. D. (2003). Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys, 56(2), 355–359. https://doi.org/10.1016/s0360-3016(02)04493-0
Miller, Keith L., Lawrence B. Marks, Gregory S. Sibley, Robert W. Clough, Jennifer L. Garst, Jeffrey Crawford, and Timothy D. Shafman. “Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer.Int J Radiat Oncol Biol Phys 56, no. 2 (June 1, 2003): 355–59. https://doi.org/10.1016/s0360-3016(02)04493-0.
Miller KL, Marks LB, Sibley GS, Clough RW, Garst JL, Crawford J, et al. Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2003 Jun 1;56(2):355–9.
Miller, Keith L., et al. “Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer.Int J Radiat Oncol Biol Phys, vol. 56, no. 2, June 2003, pp. 355–59. Pubmed, doi:10.1016/s0360-3016(02)04493-0.
Miller KL, Marks LB, Sibley GS, Clough RW, Garst JL, Crawford J, Shafman TD. Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2003 Jun 1;56(2):355–359.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

June 1, 2003

Volume

56

Issue

2

Start / End Page

355 / 359

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Radiotherapy Dosage
  • Radiotherapy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Lung Neoplasms