Improved local control with higher doses of radiation in large-volume stage III non-small-cell lung cancer

Ramesh Rengan, Kenneth E. Rosenzweig, Ennapadam Venkatraman, Lawrence A. Koutcher, Jana L. Fox, Reena Nayak, Howard Amols, Ellen Yorke, Andrew Jackson, C. Clifton Ling, Steven A. Leibel

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123 Scopus citations

Abstract

Purpose It has been suggested that larger tumor volume is associated with poor survival in patients with non-small-cell lung cancer (NSCLC). We investigated whether high-dose radiation improved local control in patients with large-volume Stage III NSCLC. Methods and materials Seventy-two patients with Stage III NSCLC and gross tumor volumes (GTV) of greater than 100 cc were treated with three-dimensional conformal radiotherapy (3D-CRT). Patients were divided into two groups: those treated to less than 64 Gy (37 patients) and those treated to 64 Gy or higher (35 patients). Results The 1-year and 2-year local failure rates were 27% and 47%, respectively, for Stage III patients treated to 64 Gy or higher, and 61% and 76%, respectively, for those treated to less than 64 Gy (p = 0.024). The median survival time for patients treated to 64 Gy or higher was 20 months vs. 15 months for those treated to less than 64 Gy (p = 0.068). Multivariate analysis revealed that dose and GTV are predictors of local failure-free survival. A 10 Gy increase in dose resulted in a 36.4% decreased risk of local failure. Conclusions Our data suggest that administration of higher doses using 3D-CRT improves local control in Stage III NSCLC patients with large GTVs.

Original languageEnglish (US)
Pages (from-to)741-747
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume60
Issue number3
DOIs
StatePublished - Nov 1 2004
Externally publishedYes

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Keywords

  • 3D-Conformal radiotherapy
  • Dose escalation
  • Local control
  • Non-small-cell lung cancer
  • Tumor volume

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Rengan, R., Rosenzweig, K. E., Venkatraman, E., Koutcher, L. A., Fox, J. L., Nayak, R., Amols, H., Yorke, E., Jackson, A., Ling, C. C., & Leibel, S. A. (2004). Improved local control with higher doses of radiation in large-volume stage III non-small-cell lung cancer. International Journal of Radiation Oncology Biology Physics, 60(3), 741-747. https://doi.org/10.1016/j.ijrobp.2004.04.013