Prospective study of special stage II (T2b-3N0M0) non-small-cell lung cancer treated with hypofractionated-simultaneous integrated boost-intensity modulated radiation therapy.

Abstract

To analyze the effects of hypofractionated-simultaneous integrated boost-intensity modulated radiation therapy (Hypo-SIB-IMRT) on medically inoperable patients with special stage II (T2b-3N0M0) non-smallcell lung cancer (NSCLC). Twenty-eight qualified patients were included. Hypo-SIB-IMRT was delivered with internal gross tumor volume (iGTV) 75 Gy, clinical target volume (CTV) 60 Gy, and planning target volume (PTV) 45 Gy on weekdays in 3 weeks. The 1-, 2-, and 3-year overall survivals (OSs) were 93, 85, and 61%, respectively, with a median survival of 46.5 months; while progression-free survivals (PFSs) were 92, 79, and 64%; and distant metastasis-free survivals (DMFSs) were 92, 84, and 77%, respectively. The cancer-specific survivals (CSS) were 93, 88, and 74%, and local control (LC) were 92, 83, and 74%, respectively. 7.1% (2/28) of patients occurred local pain, 28.6% (8/28) were with Grade 1 or 2 radiation pneumonitis (RP), and 7.1% (2/28) with Grade 1 esophagitis. Of the eight patients with RP, 17.9% (5/28) developed Grade 1 radiation pulmonary fibrosis (RPF). Due to the favorable long-term survivals, LC, and minimal toxicities, Hypo-SIB-IMRT presented in this prospective study may be considered an option for patients with special stage II (T2b-3N0M0) NSCLC who were medically inoperable.