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• W2000401971 abstract "In the management of locally advanced non-small cell lung cancer (NSCLC), concurrent chemoradiotherapy (CCRT) is considered as the standard of care. However, radiation pneumonitis (RP) is a major dose-limiting adverse effect. We have used lung dose/volume constraint on V20 ≤ 30% for patient with NSCLC treated with CCRT based on our previous investigation (IJROBP55:110–5, 2003) since 2001. A concern on this policy is it might deteriorate tumor control and survival rate. Thus, the purpose of this study is to investigate whether this dose/volume constraint decrease the incidence of RP without compromising the treatment outcome in locally advanced NSCLC. Study subjects were consisted of 93 patients before the introduction of lung dose/volume constraint on V20 (98/10–00/9, Group A) and 109 patients after the introduction (01/10–04/9, Group B) diagnosed as stage IIIA/B locally advanced inoperable NSCLC without malignant pleural effusion and radical chemotherapy and/or radiotherapy were intended at our institute. Ages were 40–80 (median 67) in Group A, 36–83 (median 67) in Group B. Stage IIIA: IIIB = 29:64 in Group A, 34:75 in Group B. Treatment outcome of all patients and the incidence of RP in patients treated with CCRT were compared between Group A and Group B. Numbers of patients treated with CCRT, sequential chemoradiation, radiotherapy alone, chemotherapy alone were 83 (89%), 2 (2.1%), 5 (5.4%), 3 (3.2%) in Group A, 67 (61.5%), 8 (7.3%), 10 (9.2%), 24 (22%) respectively in Group B (p < 0.001). Chemotherapy alone was selected because of unacceptable radiation fields in 14/24 patients in Group B. Elective nodal irradiation was omitted in 10/67 patients in patients treated with CCRT in GroupB whereas 1/83 patient in GroupA (p = 0.001). Median follow-up periods of surviving patients were 17.5 months in Group A, 14.1 months in Group B. The 3-year overall survival rates of Group A and Group B patients were 29.7% and 33.7% respectively (p = 0.54). The 3-year relapse free survival rates of Group A and Group B were 12.4% and 16.4% (p = 0.55). The 3-year local-regional control rates of Group A and Group B were 27.1% and 25.2% respectively (p = 0.75). In patient treated with CCRT, the actuarial incidence of RP greater than grade 2 (NCI-CTC ver.2) at 12 months were 25.5% in Group A, 20.0% in Group B (p = 0.45). The distribution of treatment modality has changed significantly between before and after the introduction of lung dose/volume constraint on V20. However, the policy to keep V20 ≤ 30% did not influence the tumor control rate nor survival rate in patients with locally advanced NSCLC. The incidence of RP greater than grade 2 has decreased even though it was not statistically significant." @default.
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• W2000401971 date "2007-11-01" @default.
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• W2000401971 title "Does the Lung Dose/Volume Constraint on V20 Reduce the Incidence of Radiation Pneumonitis Without Compromising Treatment Outcome in Patients With Locally Advanced Non-Small Cell Lung Cancer?" @default.
• W2000401971 doi "https://doi.org/10.1016/j.ijrobp.2007.07.1700" @default.
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