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Ruysscher, Dirk de; Wanders, Rinus; Haren, Erik van; Hochstenbag, Monique; Geraedts, Wiel; Pitz, Cordula; Simons, Jean; Boersma, Liesbeth; Verschueren, Tom; Minken, Andre; Bentzen, Soren M.; Lambin, Philippe, E-mail: dirk.deruysscher@maastro.nl2008
AbstractAbstract
[en] Purpose: To determine the feasibility of high-dose continuous hyperfractionated accelerated radiotherapy in patients with inoperable non-small-cell lung cancer (NSCLC). Patients and Methods: In a prospective, Phase I/II study, according to the risk for radiation pneumonitis, three risk groups were defined: V20 <25%, V20 25-37%, and V20 >37%. The dose was administered in three steps from 61.2 Gy/34 fractions/23 days to 64.8 Gy/36 fractions/24 days to 68.40 Gy/38 fractions/25 days (1.8 Gy b.i.d. with 8-h interval), using a three-dimensional conformal technique. Only the mediastinal lymph node areas that were positive on the pretreatment 18F-deoxy-D-glucose positron emission tomography scan were included in the target volume. The primary endpoint was toxicity. Results: A total of 48 Stage I-IIIB patients were included. In all risk groups, 68.40 Gy/38 fractions/25 days could be administered. Maximal toxicity according to the risk groups was as follows: V20 <25% (n = 35): 1 Grade 4 (G4) lung and 1 G3 reversible esophageal toxicity; V20 35-37% (n = 12): 1 G5 lung and 1 G3 reversible esophageal toxicity. For the whole group, local tumor recurrence occurred in 25% (95% confidence interval 14%-40%) of the patients, with 1 of 48 (2.1%; upper one-sided 95% confidence limit 9.5%) having an isolated nodal recurrence. The median actuarial overall survival was 20 months, with a 2-year survival rate of 36%. Conclusions: High-dose continuous hyperfractionated accelerated radiotherapy up to a dose of 68.40 Gy/38 fractions/25 days (a biologic equivalent of approximately 80 Gy when delivered in conventional fractionation) in patients with inoperable NSCLC and a V20 up to 37% is feasible
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Source
2007 interorganizational symposium on quality assurance of radiation therapy: Challenges of advanced technology; Dallas, TX (United States); 20-22 Feb 2007; S0360-3016(07)04379-9; Available from http://dx.doi.org/10.1016/j.ijrobp.2007.09.048; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Record Type
Journal Article
Literature Type
Conference
Journal
International Journal of Radiation Oncology, Biology and Physics; ISSN 0360-3016;
; CODEN IOBPD3; v. 71(1); p. 132-138

Country of publication
ANTIMETABOLITES, BETA DECAY RADIOISOTOPES, BETA-PLUS DECAY RADIOISOTOPES, BODY, COMPUTERIZED TOMOGRAPHY, DIAGNOSTIC TECHNIQUES, DISEASES, DOSES, DRUGS, EMISSION COMPUTED TOMOGRAPHY, FLUORINE ISOTOPES, HOURS LIVING RADIOISOTOPES, ISOMERIC TRANSITION ISOTOPES, ISOTOPES, LIGHT NUCLEI, LYMPHATIC SYSTEM, MEDICINE, NANOSECONDS LIVING RADIOISOTOPES, NEOPLASMS, NUCLEAR MEDICINE, NUCLEI, ODD-ODD NUCLEI, ORGANS, RADIOISOTOPES, RADIOLOGY, RESPIRATORY SYSTEM, SEPARATION PROCESSES, THERAPY, TOMOGRAPHY
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