RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal.
RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal.
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DOI：
10.1016/j.ijrobp.2012.09.023
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发表时间：
2013-05-01
影响因子：
7
通讯作者：
Willett, Christopher G.
中科院分区：
文献类型：
--
作者：
Kachnic, Lisa A.;Winter, Kathryn;Myerson, Robert J.;Goodyear, Michael D.;Willins, John;Esthappan, Jacqueline;Haddock, Michael G.;Rotman, Marvin;Parikh, Parag J.;Safran, Howard;Willett, Christopher G.
一项多机构II期试验评估了剂量描绘IMRT（DP-IMRT）在减少肛门癌5-氟尿嘧啶（5 FU）和丝裂霉素C（MMC）放化疗的2+级联合急性胃肠道和泌尿生殖系统不良事件（AE）方面的效用，与RTOG 9811的常规放疗/5 FU/MMC组相比至少减少15%。T2- 4 N 0 - 3 M0肛门癌患者在第1天和第29天接受了DP-IMRT的5 FU和MMC，按阶段开具处方-T2 N 0：42 Gy选择性淋巴结和50.4 Gy肛门肿瘤计划靶体积（PTV），分28次; T3- 4 N 0 -3：45 Gy选择性淋巴结，50.4 Gy ≤ 3 cm或54 Gy> 3 cm转移性淋巴结和54 Gy肛门肿瘤PTV，分30次。主要终点如上所述。计划的次要终点评估了所有AE和研究者进行DP-IMRT的能力。在63例累积患者中，52例可评价。肿瘤分期包括：54% II、25% IIIA、21% IIIB。在主要终点分析中，77%发生了2+级胃肠道/泌尿生殖系统急性AE（9811 77%）。然而，DP-IMRT组急性2级+血液学AE显著减少73%（9811 85%，P=0.032），3级+胃肠道AE显著减少21%（9811 36%，P=0.0082），3级+皮肤病AE显著减少23%（9811 49%，P<0.0001）。在最初的治疗前审查中，81%的患者需要重新计划DP-IMRT，而最终审查显示只有3例正常组织严重偏离。虽然没有达到主要终点，但DP-IMRT与急性2级+血液学和3级+皮肤和胃肠道毒性的显著保留相关。虽然DP-IMRT被证明是可行的，但高治疗前计划修订率强调了IMRT试验实时辐射质量保证的重要性。
A multi-institutional phase II trial assessed the utility of dose-painted IMRT (DP-IMRT) in reducing grade 2+ combined acute gastrointestinal and genitourinary adverse events (AEs) of 5-fluorouracil (5FU) and mitomycin-C (MMC) chemoradiation for anal cancer by at least 15% as compared to the conventional radiation/5FU/MMC arm from RTOG 9811. T2-4N0-3M0 anal cancer patients received 5FU and MMC days 1 and 29 of DP-IMRT, prescribed per stage - T2N0: 42Gy elective nodal and 50.4Gy anal tumor planning target volumes (PTVs) in 28 fractions; T3-4N0-3: 45Gy elective nodal, 50.4Gy ≤ 3cm or 54Gy > 3cm metastatic nodal and 54Gy anal tumor PTVs in 30 fractions. The primary endpoint is described above. Planned secondary endpoints assessed all AEs and the investigator’s ability to perform DP-IMRT. Of 63 accrued patients, 52 were evaluable. Tumor stage included: 54% II, 25% IIIA, 21% IIIB. In primary endpoint analysis, 77% experienced grade 2+ gastrointestinal/genitourinary acute AEs (9811 77%). There was, however, a significant reduction in acute grade 2+ hematologic, 73% (9811 85%, P=0.032), grade 3+ gastrointestinal, 21% (9811 36%, P=0.0082), and grade 3+ dermatologic AEs 23% (9811 49%, P<0.0001) with DP-IMRT. On initial pre-treatment review, 81% required DP-IMRT re-planning, while final review revealed only three cases with normal tissue major deviations. Although the primary endpoint was not met, DP-IMRT was associated with significant sparing of acute grade 2+ hematologic, and grade 3+ dermatologic and gastrointestinal toxicity. While DP-IMRT proved feasible, the high pre-treatment planning revision rate emphasizes the importance of real-time radiation quality assurance for IMRT trials.
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影响因子：
45.3
作者：
Salama, Joseph K.;Mell, Loren K.;Chmura, Steven J.
通讯作者：
Chmura, Steven J.
DOI：
10.1016/j.ijrobp.2007.08.074
发表时间：
2008-04-01
影响因子：
7
作者：
Mell, Loren K.;Schomas, David A.;Chmura, Steven J.
通讯作者：
Chmura, Steven J.
影响因子：
3.9
作者：
NIGRO, ND;VAITKEVICIUS, VK;CONSIDINE, B
通讯作者：
CONSIDINE, B
DOI：
10.1016/j.ijrobp.2008.08.070
发表时间：
2009-07-01
影响因子：
7
作者：
Myerson, Robert J.;Garofalo, Michael C.;El Naqa, Issam;Abrams, Ross A.;Apte, Aditya;Bosch, Walter R.;Das, Prajnan;Gunderson, Leonard L.;Hong, Theodore S.;Kim, J. J. John;Willett, Christopher G.;Kachnic, Lisa A.
通讯作者：
Kachnic, Lisa A.
DOI：
10.1016/j.ijrobp.2007.09.018
发表时间：
2008-03-01
影响因子：
7
作者：
Cannon, Donald M.;Lee, Nancy Y.
通讯作者：
Lee, Nancy Y.