Dose escalation model for limited-stage small-cell lung cancer

Noah B. Arvidson, Deepak Khuntia, Wolfgang A. Tome

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and purpose: To construct a model for the local dose-response relationship of limited-stage small-cell lung cancer (LS-SCLC) along with subsequent models for dose-per-fraction escalation. Materials and methods: Reported doses and 2-year progression free survival (PFS2year) rates from LS-SCLC studies were used to construct a dose-response model. Modeling incorporated effects of chemotherapy, incomplete repair of sublethal damage and variations in both kick-off time for rapid reproliferation and effective tumor cell doubling time. Response was modeled as a function of overall treatment duration in order to shed light on the optimum radiotherapy treatment duration. Subsequent models were constructed for more aggressive radiotherapy by means of dose-per-fraction escalation for once a day (QD) and twice a day (BID) fractionation schedules. Results: Modeling response as a function of treatment duration resulted in an optimum treatment duration of 3 weeks for both fractionation schedules. Modeling for dose-per-fraction escalation resulted in an increase in the expected local PFS2year for both fractionation schedules with possible gains in a BID schedule with lower expected late complication rates than a QD schedule yielding the same expected local PFS2year. Conclusions: This modeling suggests more aggressive treatment through escalation of dose-per-fraction, which may result in substantial gains in local PFS2year. This points towards treatment durations of 3 weeks as being optimal with a BID schedule predicting possible gains in local PFS2year at lower rates of expected late complications than a QD schedule.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalRadiotherapy and Oncology
Volume91
Issue number3
DOIs
StatePublished - Jun 2009
Externally publishedYes

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Small Cell Lung Carcinoma
Appointments and Schedules
Radiotherapy
Therapeutics
Disease-Free Survival
Drug Therapy
Neoplasms

Keywords

  • Dose escalation
  • Dose-response
  • Fractionation
  • Limited-stage small-cell lung cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Dose escalation model for limited-stage small-cell lung cancer. / Arvidson, Noah B.; Khuntia, Deepak; Tome, Wolfgang A.

In: Radiotherapy and Oncology, Vol. 91, No. 3, 06.2009, p. 379-385.

Research output: Contribution to journalArticle

Arvidson, Noah B. ; Khuntia, Deepak ; Tome, Wolfgang A. / Dose escalation model for limited-stage small-cell lung cancer. In: Radiotherapy and Oncology. 2009 ; Vol. 91, No. 3. pp. 379-385.
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