1. Surgical complications and clinical outcomes after dose-escalated trimodality therapy for non-small cell lung cancer in the era of intensity-modulated radiotherapy
- Author
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Liu, Kevin X, Sierra-Davidson, Kailan, Tyan, Kevin, Orlina, Lawrence T, Marcoux, J Paul, Kann, Benjamin H, Kozono, David E, Mak, Raymond H, White, Abby, and Singer, Lisa
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Cancer ,Lung Cancer ,Clinical Research ,Lung ,Patient Safety ,Evaluation of treatments and therapeutic interventions ,6.5 Radiotherapy and other non-invasive therapies ,Aged ,Carcinoma ,Non-Small-Cell Lung ,Chemoradiotherapy ,Disease-Free Survival ,Female ,Humans ,Lung Neoplasms ,Radiotherapy Dosage ,Radiotherapy ,Intensity-Modulated ,Retrospective Studies ,Non-small cell lung cancer ,Trimodality ,Radiation ,Intensity modulated radiotherapy ,IMRT ,Radiation dose ,Other Physical Sciences ,Oncology & Carcinogenesis ,Clinical sciences ,Oncology and carcinogenesis ,Medical and biological physics - Abstract
BackgroundTrimodality therapy (TMT) with preoperative chemoradiation followed by surgical resection is used for locally-advanced non-small-cell lung cancer (LA-NSCLC). Traditionally, preoperative radiation doses ≤54 Gy are used due to concerns regarding excess morbidity, but little is known about outcomes and toxicities after TMT with intensity-modulated radiotherapy (IMRT) to higher doses.MethodsA retrospective analysis of patients who received planned TMT with IMRT for LA-NSCLC at Brigham and Women's Hospital/Dana-Farber Cancer Institute between 2008 and 2017 was performed. Clinical and treatment characteristics, pathologic response, and surgical toxicity were assessed. Kaplan-Meier method and log-rank test was used for survival outcomes. Cox proportional-hazards regression was used for multivariable analysis.ResultsForty-six patients received less than definitive doses of 7 days were associated with OS.ConclusionsWith IMRT, there was no increased rate of surgical complications in patients receiving higher doses of radiation. Survival outcomes or LOS did not differ based on radiation dose, but increased LOS was associated with worse OS. Larger prospective studies are needed to further examine outcomes after IMRT in patients with LA-NSCLC receiving TMT.
- Published
- 2021