Phase I study of hypofractionated dose-escalated thoracic radiotherapy for limited-stage small-cell lung cancer

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• 作者：Don Yee ; Ross Halperin ; John Hanson ; Tirath Nijjar ; Charles Butts ; Michael Smylie ; Tony Reiman and Wilson Roa
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2006
• 出版时间：1 June 2006
• 年：2006
• 卷：65
• 期：2
• 页码：466-473
• 全文大小：148 K

文摘

Purpose: To determine the maximal tolerated dose of hypofractionated thoracic radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer patients.

Methods and Materials: Three radiotherapy regimens were used. Radiotherapy was given in two phases: patients initially received 20 Gy in 10 fractions to gross tumor plus uninvolved mediastinal nodes, followed by a boost to gross disease of 30, 38, or 42 Gy in 15 fractions. Radiotherapy was planned with conformal techniques. All patients received four cycles of cisplatin (25 mg/m²) and etoposide (100 mg/m²) chemotherapy. Radiotherapy commenced with Day 1 of Cycle 2 of chemotherapy. All complete/near-complete responders were offered prophylactic cranial irradiation. The maximal tolerated dose of radiotherapy was based on the dose that caused unacceptably high rates of radiotherapy-related toxicity.

Results: Thirteen patients were accrued. All patients who commenced radiotherapy received all prescribed chemo- and radiotherapy. There were no treatment-related deaths. There was one Grade 3 acute nonhematologic toxicity in the 50-Gy group. Of the 6 patients given 58 Gy, 3 experienced acute Grade 3 esophagitis. With a median follow-up of 7 months, median overall survival was 9.5 months.

Conclusions: The maximal tolerated dose of thoracic radiotherapy with concurrent chemotherapy on this trial was 50 Gy in 25 daily fractions.