TY - JOUR
T1 - Individualised isotoxic accelerated radiotherapy and chemotherapy are associated with improved long-term survival of patients with stage III NSCLC: A prospective population-based study
AU - De Ruysscher, Dirk
AU - van Baardwijk, Angela
AU - Steevens, Jessie
AU - Botterweck, Anita
AU - Bosmans, Geert
AU - Reymen, Bart
AU - Wanders, Rinus
AU - Borger, Jacques
AU - Dingemans, Anne-Marie C.
AU - Bootsma, Gerben
AU - Pitz, Cordula
AU - Lunde, Ragnar
AU - Geraedts, Wiel
AU - Oellers, Michel
AU - Dekker, Andre
AU - Lambin, Philippe
PY - 2012/2
Y1 - 2012/2
N2 - Background: Individualised, isotoxic, accelerated radiotherapy (INDAR) allows the delivery of high biological radiation doses, but the long-term survival associated with this approach is unknown. Methods: Patients with stage III NSCLC in the Netherlands Cancer Registry/Limburg from January 1, 2002 to December 31, 2008 were included. Results: Patients (1002) with stage HI NSCLC were diagnosed, of which 938 had T4 and/or N2-N3 disease. Patients treated with curative intent were staged with FDG-PET scans and a contrast-enhanced CT or an MRI of the brain. There were no shifts over time in the patient or tumour characteristics at diagnosis. The number of stage III NSCLC patients remained stable over time, but the proportion treated with palliative intent decreased from 47% in 2002 to 37% in 2008, and the percentage treated with chemo-radiation (RT) increased from 24.6% in 2002 to 47.8% in 2008 (p <0.001). The proportion of surgical patients remained below 5%. Sequential chemotherapy and conventional RT resulted in a median and a 5-year survival of 17.5 months and 8.4%, respectively, whereas with sequential chemotherapy and INDAR this was 23.6 months and 31%, respectively (p <0.001). Concurrent chemotherapy and INDAR was associated with a median and 2-year survival that was not reached and 66.7%, respectively (p = 0.004). Conclusions: The proportion of patients treated with a curative intention with chemo-RT has increased markedly over time of observation. INDAR is associated with longer survival when compared to standard dose RT alone given with or without chemotherapy.
AB - Background: Individualised, isotoxic, accelerated radiotherapy (INDAR) allows the delivery of high biological radiation doses, but the long-term survival associated with this approach is unknown. Methods: Patients with stage III NSCLC in the Netherlands Cancer Registry/Limburg from January 1, 2002 to December 31, 2008 were included. Results: Patients (1002) with stage HI NSCLC were diagnosed, of which 938 had T4 and/or N2-N3 disease. Patients treated with curative intent were staged with FDG-PET scans and a contrast-enhanced CT or an MRI of the brain. There were no shifts over time in the patient or tumour characteristics at diagnosis. The number of stage III NSCLC patients remained stable over time, but the proportion treated with palliative intent decreased from 47% in 2002 to 37% in 2008, and the percentage treated with chemo-radiation (RT) increased from 24.6% in 2002 to 47.8% in 2008 (p <0.001). The proportion of surgical patients remained below 5%. Sequential chemotherapy and conventional RT resulted in a median and a 5-year survival of 17.5 months and 8.4%, respectively, whereas with sequential chemotherapy and INDAR this was 23.6 months and 31%, respectively (p <0.001). Concurrent chemotherapy and INDAR was associated with a median and 2-year survival that was not reached and 66.7%, respectively (p = 0.004). Conclusions: The proportion of patients treated with a curative intention with chemo-RT has increased markedly over time of observation. INDAR is associated with longer survival when compared to standard dose RT alone given with or without chemotherapy.
KW - Non-small cell lung cancer
KW - Radiotherapy
KW - Chemotherapy
KW - Stage III
KW - Combined modality treatment
KW - Individualised
U2 - 10.1016/j.radonc.2011.10.010
DO - 10.1016/j.radonc.2011.10.010
M3 - Article
C2 - 22100659
SN - 0167-8140
VL - 102
SP - 228
EP - 233
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -