The efficacy analysis of simultaneous integrated boost intensity-modulated radiotherapy for locally advanced non-small cell lung cancer

Abstract

Objective To investigate the clinical efficacy and toxicity in the use of simultaneous integrated boost intensity modulated radiation therapy (SIB-IMRT) for inoperable locally advanced non-small cell lung cancer (LA-NSCLC). Methods Between February 2012 and July 2015, 58 pathologically diagnosed inoperable LA-NSCLC patients treated with SIB-IMRT were analyzed. A radiation dose of 50-64 Gy was administered in 1.8-2.2 Gy/fraction (26-30 fractions) to the planning target volume (PTV). Simultaneously, 60-70 Gy was administered in 2.0-2.35 Gy/fraction (26-30 fractions) to the planning gross tumor volume (PGTV). Results The median follow-up time was 28.0 months (ranging from 6.0 to 40.0 months). The median overall survival (OS) and progress-free survival (PFS) were 25.0 (95% CI: 23.8-26.2) and 15.0 (95% CI: 11.3-18.7) months, respectively. The 1-, 2-year OS were 91.4% and 51.7%, respectively. The 1-, 2-year PFS were 56.9% and 22.7%, respectively. None of the patients developed grade 4 or 5 pneumonitis and esophagitis. In addition, in the subgroup analysis, the patients with N3 have a higher incident of ≥ grade 2 esophagitis compared with N0-N2, the incident are 29.2% and 20.6%, respectively (P<0.05). Conclusions SIB-IMRT is feasible and well-tolerated for inoperable LA-NSCLC patients. It remains to be further evaluated in a large sample size prospective clinical trial. Key words: Radiotherapy, intensity-modulated; Carcinoma, non-small-cell lung/RT