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Volume 4, Number 2, 1999

Dose escalation using 3-dimensional conformal radiotherapy in management of non-small cell lung cancer; preliminary results on 22 patients

Kępka L, Kukołowicz P, Fijuth J.


Purpose: To determine the feasibility of radiation dose escalation > 70 Gy to Gross Tumour Volume (GTV) using 3-Dimensional Conformal Radiotherapy (3-DCRT).
Methods and Materials: From December 1997 to November 1998, 22 patients with non-small cell lung cancer
(NSCLC) were included. Tumour stage was l in 3 cases, II in 6 cases, III in 10 cases, and there were 3 locoregional recurrences after surgery. A 3-D treatment planning system with BEV was used for all patients.
Patients underwent limited elective nodal irradiation of 56 Gy. The GTV with 1 cm margin received a dose of at
least 70 Gy. Acute and late toxicity were estimated according to the RTOG/EORTC score.
Results: The mean follow-up was 217 (80-360) days. Seventeen patients received 74 Gy, two had 72 Gy, and
one had 70 Gy. In one patient with the largest irradiation volume a toxic death due to radiation pneumonitis
occurred. Except this fatality acute toxicity was acceptable. Seventeen patients were evaluable for response.
There were 3 (18%) complete responses; all in patients staged l and II, seven (41%) partial responses, 5 (29%)
non-responses and two (12%) local progressions. Two local progressions and two distant failures occured in
stage III patients.
Conclusions: Dose escalation >70 Gy using 3-DCRT in management of NSCLC is feasible with acceptable
acute toxicity.

Signature: Rep Pract Oncol Radiother, 1999; 4(2) : 29-37


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