ArticleRadiation oncology (London, England)2019
Initial report on feasibility of PET/CT-based image-guided moderate hypofractionated thoracic irradiation in node-positive non-small cell lung Cancer patients with poor prognostic factors and strongly diminished lung function: a retrospective analysis.
Article in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 12 citations in OpenAlex.
- Prognostic Factors and Survival in Surgically Treated Stage III Non-Small Cell Lung Cancer: A Real-World Single-Center Retrospective Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- Article
- MR-guided radiotherapy in node-positive non-small cell lung cancer and severely limited pulmonary reserve: a report proposing a new clinical pathway for the management of high-risk patients.Radiation oncology (London, England) · 2022Article
- Timing of tumor-induced atelectasis resolution and pulmonary function restoration in the course of image-guided moderate hypofractionated thoracic irradiation: a case report and mini-review of literature.BJR case reports · 2022Article
- [F18] FDG-PET/CT for manual or semiautomated GTV delineation of the primary tumor for radiation therapy planning in patients with esophageal cancer: is it useful?Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
- X-change symposium: status and future of modern radiation oncology-from technology to biology.Radiation oncology (London, England) · 2021Review
- Hypofractionated Volumetric-Modulated Arc Radiotherapy for Patients With Non-Small-Cell Lung Cancer Not Suitable for Surgery or Conventional Chemoradiotherapy or SBRT.Frontiers in oncology · 2021Article
- Enlarged Mediastinal Lymph Nodes in Computed Tomography are a Valuable Prognostic Factor in Non-Small Cell Lung Cancer Patients with Pathologically Negative Lymph Nodes.Cancer management and research · 2020Article
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8 authors at 2 institutions in 1 country.
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Abstract
backgroundTo determine the feasibility of PET/CT-based image-guided moderate hypofractionated thoracic irradiation (Hypo-IGRT) in locally advanced node-positive non-small cell lung cancer patients with highly compromised pulmonary function.
methodEight highly-selected and closely monitored patients with highly diminished pulmonary function (FEV1 ≤ 1.0 L and/or DLCO-SB ≤ 40% and/or on long-term oxygen therapy) were treated with Hypo-IGRT. Planning was based on 18F-FDG-PET/CT and 4D-CT in the treatment position. Hypo-IGRT was delivered to a total dose of 45 Gy (ICRU) in 15 daily fractions under strict image-guidance. Vital capacity (VC), forced expiratory volume in 1 s (FEV1), and single-breath diffusing capacity of the lung for CO (DLCO-SB) were analyzed prior to, 3 and 6 months after Hypo-IGRT.
resultEight patients with stage IIIA-C NSCLC (8th TNM Ed.) completed Hypo-IGRT. The median follow-up was 29.4 months. The median age was 64 years. Four, three and one patient(s) presented with COPD GOLD IV, III and II, respectively and 5 patients (63%) were on long-term oxygen therapy. The median PTV was 226.9 cc (range: 100.17-379.80 cc). Median PFS and OS were 19 and 34.3 months. The 6 months and 1-year OS rates were 100, 87.5%, respectively. The 6- and 12- months PFS rates were 87.5 and 52.5%. Three patients developed local failure. Median initial VC, FEV1 and DLCO-SB was 1.69 L/64.8% predicted (range: 1.36-2.66 L/33-80%), 1 L/39.4% predicted (range:0.78-1.26 L/28-60% predicted) and 33.3% (range: 13.3-54%) predicted, respectively. Median values for VC, FEV1, DLCO-SB 3 and 6 months after Hypo-IGRT were 2.05 L/56.35% predicted (range: 1.34-2.33 L/47-81.5%), 1.08 L/47.5% predicted (range: 0.74-1.60 L/30.8-59.59%), 38.55% (range: 24-68%) and 1.64 L/66% predicted (range: 1.41-2.79/35.5-75.5%), 1.0 L/47% predicted (range: 0.65-1.28 L/24.5-54.10%), 31% (range: 27-43%), respectively. Mean lung dose was 9.4 Gy (range: 5.3-11.6 Gy) and V20 for both lungs was 15% (range: 6-19%). Mean esophageal dose was 12.76 Gy (range: 2.1-26.7 Gy). There was no case of grade 2 or higher radiation pneumonitis. Four patients developed grade 2 radiation esophagitis.
conclusionHypo-IGRT can be considered for individual and closely monitored patients with locally advanced node-positive NSCLC with highly compromised pulmonary function. No severe pulmonary toxicity and significant decline of pulmonary function parameters was observed in our cohort. Currently, this protocol is being assessed in an ongoing single-centre prospective study.
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