Samenvatting
Purpose or Objective: Intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are widely used in the treatment of advanced stage non-small cell lung cancer (NSCLC). These techniques deliver conformal dose distributions at the cost of increased target dose heterogeneity (particularly IMRT) and larger volumes of surrounding healthy tissues receiving low doses (particularly VMAT). We evaluated whether these dosimetric differences between IMRT and VMAT are of influence on treatment toxicity and outcome. Material and Methods: We retrospectively assessed a cohort of 189 consecutive patients with stage III NSCLC having undergone radical (chemo-)radiotherapy using IMRT (until 2011) or VMAT (starting in 2011 ). Most patients (n=182) received 66 Gy in 33 (once-daily) fractions to the primary tumour and involved hilar/mediastinal lymph nodes based on FDG-PET/CT. Concurrent chemoradiation (CCR; n=122) consisted of 2 courses of etoposide cisplatinum, whereas sequential treatment (n=56) consisted of 3 courses of gemcitabine cisplatinum. Acute and late toxicity were assessed using the RTOG radiation morbidity scoring criteria for esophageal and pulmonary toxicity. Follow-up visits were planned every 3 months (first 2 years), biannually thereafter. Median overall survival (OS) was calculated using Kaplan- Meyer survival analysis. Differences between the groups receiving IMRT and VMAT were statistically tested using the Mann-Whitney-U or Chi-square test, where appropriate. Results: Gender, age, performance score, clinical (tumour and nodal) stage and radiation dose did not significantly differ between the IMRT (n=93) and VMAT (n=96) groups. Patients undergoing IMRT, however, received less concurrent chemotherapy compared to patients treated with VMAT (n=51 vs n=71; p= 0.007). Incidences of grade ≥2 and ≥3 acute esophageal toxicity (AET) were significantly lower for IMRT compared to VMAT (28 vs 57 patients, p
Originele taal-2 | English |
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Pagina's (van-tot) | S317-S317 |
Aantal pagina's | 1 |
Tijdschrift | Radiotherapy and Oncology |
Volume | 119 |
DOI's | |
Status | Published - apr.-2016 |
Extern gepubliceerd | Ja |