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Jiang C, Han S, Chen W, Ying X, Wu H, Zhu Y, Shi G, Sun X, Xu Y. A retrospective study of shrinking field radiation therapy during chemoradiotherapy in stage III non-small cell lung cancer. Oncotarget 2018; 9:12443-12451. [PMID: 29552324 PMCID: PMC5844760 DOI: 10.18632/oncotarget.23849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 10/26/2017] [Indexed: 12/25/2022] Open
Abstract
Background and purpose: This retrospective study aimed to investigate the feasibility of shrinking field radiotherapy during chemoradiotherapy in non-small cell lung cancer (NSCLC). Patients and methods Ninety-seven patients with stage III NSCLC who achieved a good response to chemoradiation were analyzed. Computed tomography was performed after 40-50 Gy dose radiation to evaluate curative effect. Patients in the shrinking field group underwent resimulation CT scans and shrinking field radiotherapy. Acute symptomatic irradiation-induced pneumonia (ASIP), progression patterns and survival were assessed. Results Of the 97 patients who achieved response after a median total dose of 60 Gy, fifty patients received shrinking field radiotherapy. The incidence of acute symptomatic irradiation-induced pneumonia tended to be lower for the shrinking field group (18.0% vs. 23.4%, P = 0.51). The rate of disease progression was significantly higher in the non-shrinking than shrinking field group (95.7% vs. 66.0%, P < 0.001). Compared to the non-shrinking field group, the shrinking field group had similar overall survival (30.0 vs. 30.0 months, P = 0.58) but significantly better median progression-free survival (14.0 vs. 11.0 months, P = 0.006). Conclusions Shrinking field radiotherapy during chemoradiotherapy in stage III non-small cell lung cancer seems safe with acceptable toxicities and relapse, and potentially spares normal tissues and enables dose escalation. Prospective trials are warranted.
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Affiliation(s)
- Chenxue Jiang
- First Clinical Medical School, Wenzhou Medical University, Wenzhou, PR China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Shuiyun Han
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Wucheng Chen
- First Clinical Medical School, Wenzhou Medical University, Wenzhou, PR China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Xiaozhen Ying
- First Clinical Medical School, Wenzhou Medical University, Wenzhou, PR China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - He Wu
- First Clinical Medical School, Wenzhou Medical University, Wenzhou, PR China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Yaoyao Zhu
- First Clinical Medical School, Wenzhou Medical University, Wenzhou, PR China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Guodong Shi
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Xiaojiang Sun
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
| | - Yaping Xu
- First Clinical Medical School, Wenzhou Medical University, Wenzhou, PR China.,Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, PR China
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