INFLUENCE OF TECHNOLOGIC ADVANCES ON OUTCOMES IN PATIENTS WITH UNRESECTABLE, LOCALLY ADVANCED NON-SMALL-CELL LUNG CANCER RECEIVING CONCOMITANT CHEMORADIOTHERAPY
INFLUENCE OF TECHNOLOGIC ADVANCES ON OUTCOMES IN PATIENTS WITH UNRESECTABLE, LOCALLY ADVANCED NON-SMALL-CELL LUNG CANCER RECEIVING CONCOMITANT CHEMORADIOTHERAPY
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DOI：
10.1016/j.ijrobp.2009.02.032
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发表时间：
2010-03-01
影响因子：
7
通讯作者：
Cox, James D.
中科院分区：
文献类型：
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作者：
Liao, Zhongxing X.;Komaki, Ritsuko R.;Cox, James D.
目的：2004年，我院开始采用四维计算机断层扫描（4DCT）模拟再调强放疗（IMRT） （4DCT/IMRT）代替三维适形放疗（3DCRT）作为非小细胞肺癌（NSCLC）的标准治疗。这项回顾性研究比较了合并化疗和4DCT/IMRT或3DCRT治疗的患者的疾病结局和毒性。方法和材料：1999年至2006年间，共有496名非小细胞肺癌患者在安德森癌症中心接受了放化疗治疗。其中CT/3DCRT 318例，4DCT/IMRT 91例。两组的中位剂量均为63戈瑞。疾病终点为局部进展（LRP）、远处转移（DM）和总生存期（OS）。疾病协变量为总肿瘤体积（GTV）、淋巴结状态和组织学。毒性终点为>= 3级放射性肺炎；毒性协变量为GTV、吸烟状况和剂量学因素。采用Cox比例风险模型对数据进行分析。结果：4DCT/IMRT组和CT/3DCRT组的平均随访时间分别为1.3（范围0.1 ~ 3.2）和2.1（范围0.1 ~ 7.9）年。4DCT/IMRT的风险比为
Purpose: In 2004, our institution began using four-dimensional computed tomography (4DCT) simulation and then intensity-modulated radiotherapy (IMRT) (4DCT/IMRT) instead of three-dimensional conformal radiotherapy (3DCRT) for the standard treatment of non-small-cell lung cancer (NSCLC). This retrospective study compares disease outcomes and toxicity in patients treated with concomitant chemotherapy and either 4DCT/IMRT or 3DCRT.Methods and Materials: A total of 496 NSCLC patients have been treated at M. D. Anderson Cancer Center between 1999 and 2006 with concomitant chemoradiotherapy. Among these, 318 were treated with CT/3DCRT and 91 with 4DCT/IMRT. Both groups received a median dose of 63 Gy. Disease end points were locoregional progression (LRP), distant metastasis (DM), and overall survival (OS). Disease covariates were gross tumor volume (GTV), nodal status, and histology. The toxicity end point was Grade >= 3 radiation pneumonitis; toxicity covariates were GTV, smoking status, and dosimetric factors. Data were analyzed using Cox proportional hazards models.Results: Mean follow-up times in the 4DCT/IMRT and CT/3DCRT groups were 1.3 (range, 0.1-3.2) and 2.1 (range, 0.1-7.9) years, respectively. The hazard ratios for 4DCT/IMRT were