Feasibility of omitting clinical target volume for limited-disease small cell lung cancer treated with chemotherapy and intensity-modulated radiotherapyReportar como inadecuado




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Radiation Oncology

, 9:17

Clinical Radiation Oncology

Abstract

PurposeTo analyze the feasibility of omitting clinical target volume CTV for limited small cell lung cancer treated with chemotherapy and intensity modulated radiotherapy.

Methods and materials89 patients were treated from January 1, 2008 to August 31, 2011, 54 cases were irradiated with target volume without CTV, and 35 cases were irradiated with CTV. Both arms were irradiated post chemotherapy tumor extent and omitted elective nodal irradiation; dose prescription was 95% PTV56-63 Gy-28-35 F-5.6-7 weeks.

ResultsIn the arm without CTV and arm with CTV, the local relapse rates were 16.7% and 17.1% p = 0.586 respectively. In the arm without CTV, of the 9 patients with local relapse, 6 recurred in-field, 2 recurred in margin, 1 recurred out of field. In the arm with CTV, of the 6 patients with local relapse, 4 recurred in-field, 1 recurred in margin, 1 recurred out of field. The distant metastases rates were 42.6% and 51.4% p = 0.274 respectively. Grade 3-4 hematological toxicity and radiation esophagitis had no statistically significant, but grade 3-4 radiation pneumonia was observed in only 7.4% in the arm without CTV, compared 22.9% in the arm with CTV p = 0.040. The median survival in the arm without CTV had not reached, compared with 38 months in the with CTV arm. The l- years, 2- years, 3- years survival rates of the arm without CTV and the arm with CTV were 81.0%, 66.2%, 61.5% and 88.6%, 61.7%, 56.6% p = 0.517. The multivariate analysis indicated that the distant metastases p = 0.000 and PCI factor p = 0.004 were significantly related to overall survival.

ConclusionsTarget delineation omitting CTV for limited-disease small cell lung cancer received IMRT was feasible. The distant metastases and PCI factor were significantly related to overall survival.

KeywordsRadiotherapy Lung cancer Limited-disease small cell lung cancer Clinical target volume Local relapse Intensity-modulated radiotherapy Radiation pneumonia AbbreviationsGTVGross tumor volume

CTVClinical target volume

ITVInternal target volume

PTVPlan target volume

SCLCSmall cell lung cancer

LSCLCLimited-disease small cell lung cancer

CTComputed tomography

ECTEmission computerized tomography

MRIMagnetic resonance imaging

PETPositron emission tomography

PCIProphylactic cranial irradiation

ENIElective nodal irradiation

CRComplete remission

PRPartial response

SDStable disease

PDProgressive disease.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-9-17 contains supplementary material, which is available to authorized users.

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Autor: Shuhua Cai - Anhui Shi - Rong Yu - Guangying Zhu

Fuente: https://link.springer.com/



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