TITLE:
Is There a Future for 74 Gy Radiation Treatment of NSCLC after RTOG 0617? A Comparison of the RTOG Study Results with Our Own Department’s 74 Gy NSCLC Cohort
AUTHORS:
Christina Schröder, Eyck Blank, Dietrich Sidow, Rita Engenhart-Cabillic, André Buchali
KEYWORDS:
Lung Cancer, Dose Escalation, Local Remission, Survival, Side Effects
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.8,
July
28,
2015
ABSTRACT: Background and
Purpose: There have been a number of different efforts trying to improve the
outcome of NSCLC patients treated with radiotherapy (RT). Contrary to most
expectations, the long awaiting results of the RTOG 0617 trial didn’t show any
benefit of dose escalation to 74 Gy. In this unicentric retrospective analysis
we compare the RTOG 0617 result with the outcome of our own 74-Gy-NSCLC cohort.
Methods and Material: Since October 2009, 80 patients with NSCLC were treated
with 74 Gy in 37 fractions, of which 69 patients were eligible for a
retrospective analysis of local and distant failure, survival time and
treatment related toxicity. A subgroup analysis was done for patients with a possible
follow-up of at least 18 month. Results: Complete local remission could be
achieved in 18 patients (26.1%); 26 patients (37.7%) had a partial remission
and 3 patients (4.4%) a stable local disease. Local failure occurred in 12
patients (17.3%). Distant failure occurred in 27 patients (39.1%). The median
survival time was 43.7 weeks (95% CI: 25.2 - 62.3 weeks). 5 patients (6.3%)
developed RT induced side effects. As for the analyzed subgroup, a complete or
partial local remission could be achieved in 29 patients (61.7%). Local failure
occurred in 11 patients (23.4%) and 20 patients (42.6%) developed distant
metastases. The 18-month overall survival was 38.3% and the median survival
time was 51.7 weeks (95% CI: 27.2 - 76.3 weeks). Conclusion: The results of
this retrospective analysis indicate that 74 Gy total radiation dose might not
lead to results as bad as indicated by the RTOG 0617 trial. It might therefore
be a suitable treatment concept for people with NSCLC.