Abstract
BACKGROUND: Adaptive strategy with daily online tumour match is a treatment option when treating locally advanced lung cancer patients with curative intended radiotherapy (RT).
MATERIAL AND METHODS: Fifty-two consecutive lung cancer patients treated with soft tissue match, adaptive RT and small planning target volumes (PTV) margins were analysed. A control group of 52 consecutive patients treated with bone match, no adaptive strategy and larger margins was included. Patients were followed with computed tomography (CT) scans every third month. CT-images showing loco-regional recurrences were identified. The recurrence gross tumour volume was delineated and registered with the original radiation treatment plan to identify site of failure. All patients were toxicity-scored using CTCAE 4.03 grading scale. Data were analysed using the Kaplan-Meier analysis.
RESULTS: The median follow-up time was 16 months (3-35). Within a year, 35% of the patients in the adaptive group (ART-group) and 53% in the control group (No-ART-group) experienced loco-regional failure, showing improved loco-regional control in the ART group (p = 0.05). One patient in the ART-group and four patients in the No-ART-group showed marginal failure. Median overall progression-free survival time for the ART-group was 10 months (95% CI 8-12), and 8 months (95% CI 6-9) for the No-ART-group. Severe pneumonitis (grade 3-5) decreased from 22% in the No-ART-group to 18% in the ART-group (non-significant, p = 0.6). No significant difference in severe dysphagia was found between the two groups.
CONCLUSION: In the first small cohort of patients investigated, implementation of soft-tissue tumour match and adaptive strategies for locally advanced lung cancer patients increased the loco-regional control rate without increasing treatment-related toxicity.
| Original language | English |
|---|---|
| Journal | Acta Oncologica |
| Volume | 54 |
| Issue | 9 |
| Pages (from-to) | 1430-1437 |
| Number of pages | 8 |
| ISSN | 0284-186X |
| DOIs | |
| Publication status | Published - 2015 |
Keywords
- Adult
- Aged
- Aged, 80 and over
- Carcinoma/diagnostic imaging
- Case-Control Studies
- Denmark/epidemiology
- Female
- Follow-Up Studies
- Humans
- Lung Neoplasms/diagnostic imaging
- Male
- Middle Aged
- Multidetector Computed Tomography
- Neoplasm Recurrence, Local/diagnostic imaging
- Radiation Pneumonitis/epidemiology
- Radiotherapy, Image-Guided
- Radiotherapy, Intensity-Modulated