![]() ![]() ![]() Patients with all stages of disease were recruited and 62% received chemotherapy in the neoadjuvant or adjuvant setting. Seventy-nine patients received dose escalated treatments based on the patients’ stratified risk for TRP in 25 daily fractions. A subsequent analysis on patient reported outcome demonstrated a significantly worse quality of life on the 74 Gy arms at 3 months after treatment. Although patients were stratified by treatment delivery technique and the proportions of patients treated with IMRT were balanced between treatment groups (46.1% in 60 Gy arms and 47.1% in 74 Gy arms), the delivery of 74 Gy was probably challenging, particularly in patients treated without IMRT, given the gross tumor volume (GTV) (mean 124.7 in 60 Gy arms and 128.5 cc in 74 Gy arms). It should be noted that just under half of the patients in this study were treated with IMRT (46.5%). The reasons for this are the subject of some debate, but possible explanations include: increased heart dose, extended therapy duration, underreported grade 5 events, compromised target coverage, or likely a combination of these factors. Surprisingly, at interim analysis the data suggested a survival disadvantage for the high-dose arm as well as inferior local control rates, indicating that dose escalation using conventional fractionation (resulting in increased overall treatment time) is not the ideal approach for NSCLC. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |