Dose intensity of radiation therapy in non-small cell carcinoma of the lung: a review of RTOG data and strategies.
Prospective trials exploring questions of dose intensity for control of the local-regional tumor have been conducted by the Radiation Therapy Oncology Group for 20 years. Early studies established radiation therapy with a total dose of 60 Gy in 30 fractions as standard (STD) for unresectable non-small cell carcinomas of the lung (NSCCL). Hyperfractionated radiation therapy (HFX) with 1.2 Gy twice daily permitted higher total doses without increased normal tissue effects and led to comparison of STD vs. HFX (total dose 69.6 Gy in 58 fractions). Induction chemotherapy followed by STD, induction followed by concurrent chemotherapy and STD, and concurrent chemotherapy and HFX, have been explored in successive trials. Preliminary results of STD combined with chemotherapy suggest that increases in dose intensity increase local-regional control and survival. Confirmatory trials of increased dose intensity by combining chemotherapy with STD and HFX have been completed or are progressing.
Cox
J D
JD
University of Texas M.D. Anderson Cancer Center, Department of Radiotherapy, Houston 77030.
Sause
W T
WT
Byhardt
R W
RW
Komaki
R
R
Perez
C A
CA
Pajak
T F
TF
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D015337:Multicenter Studies as Topic / Q000379:methods / Q000592:standards; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards; D015996:Survival Rate; D014747:Vinblastine / Q000008:administration & dosage
D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin