Radiation therapy intensification for solid tumors

A systematic review of randomized trials

Yamoah Kosj, Timothy N. Showalter, Nitin Ohri

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose To systematically review the outcomes of randomized trials testing radiation therapy (RT) intensification, including both dose escalation and/or the use of altered fractionation, as a strategy to improve disease control for a number of malignancies. Methods and Materials We performed a literature search to identify randomized trials testing RT intensification for cancers of the central nervous system, head and neck, breast, lung, esophagus, rectum, and prostate. Findings were described qualitatively. Where adequate data were available, pooled estimates for the effect of RT intensification on local control (LC) or overall survival (OS) were obtained using the inverse variance method. Results In primary central nervous system tumors, esophageal cancer, and rectal cancer, randomized trials have not demonstrated that RT intensification improves clinical outcomes. In breast cancer and prostate cancer, dose escalation has been shown to improve LC or biochemical disease control but not OS. Radiation therapy intensification may improve LC and OS in head and neck and lung cancers, but these benefits have generally been limited to studies that did not incorporate concurrent chemotherapy. Conclusions In randomized trials, the benefits of RT intensification have largely been restricted to trials in which concurrent chemotherapy was not used. Novel strategies to optimize the incorporation of RT in the multimodality treatment of solid tumors should be explored.

Original languageEnglish (US)
Pages (from-to)737-745
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume93
Issue number4
DOIs
StatePublished - 2015

Fingerprint

radiation therapy
Radiotherapy
tumors
cancer
Neoplasms
central nervous system
chemotherapy
breast
lungs
Prostatic Neoplasms
esophagus
Drug Therapy
rectum
Central Nervous System Neoplasms
dosage
Esophageal Neoplasms
Rectal Neoplasms
Head and Neck Neoplasms
Rectum
fractionation

ASJC Scopus subject areas

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

Cite this

Radiation therapy intensification for solid tumors : A systematic review of randomized trials. / Kosj, Yamoah; Showalter, Timothy N.; Ohri, Nitin.

In: International Journal of Radiation Oncology Biology Physics, Vol. 93, No. 4, 2015, p. 737-745.

Research output: Contribution to journalArticle

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