Is Intermediate Radiation Dose Escalation With Concurrent Chemotherapy for Stage III Non-Small-Cell Lung Cancer Beneficial? A Multi-Institutional Propensity Score Matched Analysis

George Rodrigues*, Cary Oberije, Suresh Senan, Kayoko Tsujino, Terry Wiersma, Marta Moreno-Jimenez, Tae Hyun Kim, Lawrence B. Marks, Ramesh Rengan, Luigi De Petris, Sara Ramella, Kim DeRuyck, Nuria Rodriguez De Dios, Andrew Warner, Jeffrey D. Bradley, David A. Palma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The clinical benefits and risks of dose escalation (DE) for stage III non-small-cell lung cancer (NSCLC) remain uncertain despite the results from Radiation Therapy Oncology Group (RTOG) protocol 0617. There is significant heterogeneity of practice, with many clinicians prescribing intermediate dose levels between the 0617 study arms of 60 and 74 Gy. This study investigated whether this strategy is associated with any survival benefits/risks by analyzing a large multi-institutional database.An individual patient database of stage III NSCLC patients treated with radical intent concurrent chemoradiation therapy was created (13 institutions, n=1274 patients). Patients were divided into 2 groups based on tumor Biological Effective Dose at 10 Gy (BED 10): those receiving standard dose (SD; n=552), consisting of 72Gy ? BED 10 ? 76.8 Gy (eg 60-64 Gy/30-32 fractions [fr]), and those receiving intermediate dose (ID; n=497), consisting of 76.8Gy <BED 10 <100.8 Gy (eg >64 Gy/32 fr and
Original languageEnglish
Pages (from-to)133-139
JournalInternational Journal of Radiation Oncology Biology Physics
Volume91
Issue number1
DOIs
Publication statusPublished - 1 Jan 2015

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