Research Papers:

Simultaneous integrated boost intensity-modulated radiotherapy for locally advanced non-small cell lung cancer in Chinese population: A retrospective study

Yujin Xu, Xiao Zheng, Xue Bai, Pu Li, Honglian Ma, Jin Wang, Xiao Hu and Ming Chen _

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Oncotarget. 2017; 8:49084-49092. https://doi.org/10.18632/oncotarget.17094

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Yujin Xu1,2, Xiao Zheng1,2, Xue Bai3, Pu Li3, Honglian Ma1,2, Jin Wang1,2, Xiao Hu1,2 and Ming Chen1,2

1Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, China

2Zhejiang Provincial Key Laboratory of Radiation Oncology, Hangzhou, 310022, China

3Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou, 310022, China

Correspondence to:

Ming Chen, email: [email protected]

Keywords: non-small cell lung cancer, integrated boost intensity-modulated radiotherapy, local control, overall survival

Received: March 03, 2017     Accepted: March 31, 2017     Published: April 13, 2017


Objectives: To evaluate the clinical efficacy and toxicity of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for patients with locally advanced non-small cell lung cancer (NSCLC).

Results: All patients completed definitive radiotherapy and 74 (85.1%) patients administrated platinum-based chemotherapy. The median radiation dose was 50.4Gy to PTV and 64.4 Gy simultaneously to the PGTV. The overall response rate (ORR) was 57.5% (50/87). The median duration of follow up was 24.6 months. The 1, 2, 3-year local control rate was 79.0%, 66.1%, and 60.5%, respectively. The 1, 2, 3-year overall survival (OS) rate was 89.7%, 56.7%, and 30.6%, respectively. Subgroup analysis showed that the median OS in concurrent chemoradiation (CCRT) was much better than non-CCRT (35.7 vs. 26.4 months) (HR: 0.52, 95% CI: 0.32–0.95, P = 0.033). Twenty-two (25.3%) patients experienced acute grade 3 esophagitis and 10 (11.5%) experienced acute grade ≥ 3 radiation pneumonitis. There were 2 (2.6%) late grade 3 pulmonary toxicity and no late grade ≥ 3 esophageal toxicity was observed.

Materials and Methods: A total of 87 patients with locally advanced NSCLC who received SIB-IMRT from Jan. 2009 to Dec. 2012 in our hospital were retrospectively analyzed. Male accounted for 88.5%, with a median age of 61 years old. The SIB-IMRT plans were designed to deliver 50.4–64.0 Gy in 28–33 fractions (1.8–2.1 Gy/fraction) to PTV while simultaneously delivering 60.0–74.3 Gy in 28–33 fractions (2.0–2.5 Gy/fraction) to PGTV.

Conclusions: SIB-IMRT, especially with concurrent chemotherapy, appears to be an effective and safe option to treat patients with locally advanced NSCLC. More prospective clinical studies should be warranted.

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