期刊
RADIOTHERAPY AND ONCOLOGY
卷 131, 期 -, 页码 166-173出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2018.09.019
关键词
Dose-escalation; Non-small cell lung cancer; PET-boost; Toxicity; Dose painting
资金
- European Commission, 7th Framework Project Grant [257144]
- Dutch Cancer Society [2010-4675]
Background and purpose: The PET-boost randomized phase II trial (NCT01024829) investigated dose-escalation to the entire primary tumour or redistributed to regions of high pre-treatment FDG-uptake in inoperable non-small cell lung cancer (NSCLC) patients. We present a toxicity analysis of the 107 patients randomized in the study. Materials and methods: Patients with stage II-III NSCLC were treated with an isotoxic integrated boost of >= 72 Gy in 24 fractions, with/without chemotherapy and strict dose limits. Toxicity was scored until death according to the CTCAEv3.0. Results: 77 (72%) patients were treated with concurrent chemoradiotherapy. Acute and late >= G3 occurred in 41% and 25%. For concurrent (C) and sequential or radiotherapy alone (S), the most common acute >= G3 toxicities were: dysphagia in 14.3% (C) and 3.3% (S), dyspnoea in 2.6% (C) and 6.7% (S), pneumonitis in 0% (C) and 6.7% (S), cardiac toxicity in 6.5% (C) and 3.3% (S). Seventeen patients died of which in 13 patients a possible relation to treatment could not be excluded. In 10 of these 13 patients progressive disease was scored. Fatal pulmonary haemorrhages and oesophageal fistulae were observed in 9 patients. Conclusion: Personalized dose-escalation in inoperable NSCLC patients results in higher acute and late toxicity compared to conventional chemoradiotherapy. The toxicity, however, was within the boundaries of the pre-defined stopping rules. (C) 2018 Elsevier B.V. All rights reserved.
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