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Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study
BACKGROUND: Intensity-modulated radiotherapy (RT) is now widely implemented and has replaced classical three-dimensional (3D)-RT in many tumor sites, as it allows a better target dose conformity and a better sparing of organs a risk (OAR), at the expense, however, of increasing the volume of low dos...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867762/ https://www.ncbi.nlm.nih.gov/pubmed/33569301 http://dx.doi.org/10.21037/tlcr-20-406 |
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author | Bourbonne, Vincent Delafoy, Alice Lucia, François Quéré, Gilles Pradier, Olivier Schick, Ulrike |
author_facet | Bourbonne, Vincent Delafoy, Alice Lucia, François Quéré, Gilles Pradier, Olivier Schick, Ulrike |
author_sort | Bourbonne, Vincent |
collection | PubMed |
description | BACKGROUND: Intensity-modulated radiotherapy (RT) is now widely implemented and has replaced classical three-dimensional (3D)-RT in many tumor sites, as it allows a better target dose conformity and a better sparing of organs a risk (OAR), at the expense, however, of increasing the volume of low dose to normal tissues. Clinical data on toxicities using volumetric modulated arc therapy (VMAT) in lung cancer remain scarce. We aimed to report both acute (APT) and late (LPT) pulmonary and acute (AET) and late (LET) oesophageal toxicities in such setting. METHODS: All patients treated for a primary lung cancer with VMAT +/− chemotherapy (ChT) in our center from 2014 to 2018 were retrospectively included. Usual clinical, treatment and dosimetric features were collected. Univariate analysis was performed using the receiver operative characteristics approach while multivariate analysis (MVA) relied on logistic regression, calculated with Medcalc 14.8.1. RESULTS: In total, 167 patients were included, with a median age of 66 years (39–88 years). Median radiation dose was 66 Gy (30–66 Gy); 82% patients received concomitant (32.3%), induction (25.7%) or induction followed by concomitant ChT (24%). After a median follow-up of 14.0 months, the G ≥2 APT, AET, LPT and LET rates were 22.2%, 30.0%, 16.8% and 5.4%, respectively with low grade ≥3 toxicity rates (respectively, 3%, 6.6%, 3% and 0%). On MVA, APT was significantly associated with V30 to the homolateral lung, AET with age, LPT with MEVS while no feature remained significantly correlated with LET. CONCLUSIONS: Low rates of pulmonary and esophageal toxicity were observed in our cohort. Larger prospective studies are needed to confirm these results. |
format | Online Article Text |
id | pubmed-7867762 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-78677622021-02-09 Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study Bourbonne, Vincent Delafoy, Alice Lucia, François Quéré, Gilles Pradier, Olivier Schick, Ulrike Transl Lung Cancer Res Original Article BACKGROUND: Intensity-modulated radiotherapy (RT) is now widely implemented and has replaced classical three-dimensional (3D)-RT in many tumor sites, as it allows a better target dose conformity and a better sparing of organs a risk (OAR), at the expense, however, of increasing the volume of low dose to normal tissues. Clinical data on toxicities using volumetric modulated arc therapy (VMAT) in lung cancer remain scarce. We aimed to report both acute (APT) and late (LPT) pulmonary and acute (AET) and late (LET) oesophageal toxicities in such setting. METHODS: All patients treated for a primary lung cancer with VMAT +/− chemotherapy (ChT) in our center from 2014 to 2018 were retrospectively included. Usual clinical, treatment and dosimetric features were collected. Univariate analysis was performed using the receiver operative characteristics approach while multivariate analysis (MVA) relied on logistic regression, calculated with Medcalc 14.8.1. RESULTS: In total, 167 patients were included, with a median age of 66 years (39–88 years). Median radiation dose was 66 Gy (30–66 Gy); 82% patients received concomitant (32.3%), induction (25.7%) or induction followed by concomitant ChT (24%). After a median follow-up of 14.0 months, the G ≥2 APT, AET, LPT and LET rates were 22.2%, 30.0%, 16.8% and 5.4%, respectively with low grade ≥3 toxicity rates (respectively, 3%, 6.6%, 3% and 0%). On MVA, APT was significantly associated with V30 to the homolateral lung, AET with age, LPT with MEVS while no feature remained significantly correlated with LET. CONCLUSIONS: Low rates of pulmonary and esophageal toxicity were observed in our cohort. Larger prospective studies are needed to confirm these results. AME Publishing Company 2021-01 /pmc/articles/PMC7867762/ /pubmed/33569301 http://dx.doi.org/10.21037/tlcr-20-406 Text en 2021 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Bourbonne, Vincent Delafoy, Alice Lucia, François Quéré, Gilles Pradier, Olivier Schick, Ulrike Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
title | Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
title_full | Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
title_fullStr | Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
title_full_unstemmed | Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
title_short | Toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
title_sort | toxicity after volumetric modulated arc therapy for lung cancer: a monocentric retrospective study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867762/ https://www.ncbi.nlm.nih.gov/pubmed/33569301 http://dx.doi.org/10.21037/tlcr-20-406 |
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