Abstract
BackgroundHypofractionated three-dimensional conformal radiation therapy (3D-CRT) is a treatment option for patients with early-stage non-small cell lung cancer (NSCLC) who are medically unable to tolerate surgery and who are not amenable to treatment with stereotactic body radiotherapy. This study assessed the efficacy and safety of 3D-CRT as a monotherapy in patients with localized stage T2 or T3 NSCLC.MethodsThis retrospective study consisted of 29 patients (20 males) aged 56–89 years (median, 76 years) with histologically confirmed NSCLC who underwent 3D-CRT between 2005 and 2014.ResultsThe median duration of patient observation was 17.0 months (range, 1.0–64.0 months). Complete and partial responses occurred in 13.8 and 44.8 % of patients, respectively, and the overall response rate was 58.2 %. Meanwhile, the 1- and 3-year survival rates were 65.8 and 33.8 %, respectively. In T2 NSCLC, the median survival time (MST) was 12 months, and the 1- and 3-year survival rates were 62.4 and 21.4 %, respectively. In T3 NSCLC, the MST was 17 months, and the 1- and 3-year survival rates were 72.9 and 48.6 %, respectively. Severe toxicities (Common Terminology Criteria Grade 3) were not observed. The mean biologically effective dose required to improve local control exceeded 80 Gy (range, 67.2–96.0 Gy).ConclusionThese findings support a role for 3D-CRT as a treatment option for patients who refuse or could not tolerate surgical therapy with early-stage NSCLC. Although this was a small, retrospective study, it may form the basis for future, larger controlled studies on 3D-CRT as a monotherapy for NSCLC.
Highlights
Three-dimensional conformal radiation therapy (3D-CRT) delivers radiation to tumors while sparing surrounding normal tissue structures
Stage T2a non-small cell lung cancer (NSCLC) was present in 18 patients, whereas nine patients were diagnosed with stage T3 disease
Stereotactic body radiotherapy (SBRT) was proactively performed in most patients with stage T1 disease, and these patients were not included in the present study
Summary
Three-dimensional conformal radiation therapy (3D-CRT) delivers radiation to tumors while sparing surrounding normal tissue structures. SBRT requires greater precision and accuracy than conventional radiotherapy, and it should be conducted according to a strict protocol [15] Patient characteristics such as tumor size, site, and general physical condition can make performing SBRT difficult. We have recently administered radiation treatment to patients with stage T2 or T3 NSCLC, in whom we increased the radiation dose to more than 5 Gy delivered in a single fraction In these patients, the radiation field is defined as the tumor plus margin, and the use of 3D-CRT is limited to patients for whom elective nodal irradiation was not conducted. Hypofractionated three-dimensional conformal radiation therapy (3D-CRT) is a treatment option for patients with early-stage non-small cell lung cancer (NSCLC) who are medically unable to tolerate surgery and who are not amenable to treatment with stereotactic body radiotherapy. This study assessed the efficacy and safety of 3D-CRT as a monotherapy in patients with localized stage T2 or T3 NSCLC
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