title: Radiotherapy for inoperable non-small cell lung cancer using helical tomotherapy.
abstract: OBJECTIVE
  To investigate the impact of tomotherapy on the dose delivered to the lungs and other normal tissues.
  
  
  METHODS
  From February 2008 to May 2009, 35 patients with stage IIIA/IIIB non-small cell lung cancer were treated with helical tomotherapy at the S. Camillo-Forlanini Hospital. For our study we selected 20 patients who underwent chemotherapy followed by sequential radiotherapy. The planning target volume was delineated using planning CT scan and FDG-PET. The mean prescribed radiation dose was 67.5 Gy delivered in 30 fractions at a dose of 2.25 Gy per fraction.
  
  
  RESULTS
  Median follow-up was 12.3 months. All patients developed acute esophageal toxicity, 15 of RTOG grade 1 and 5 of RTOG grade 2. At first follow-up 15 patients presented stable disease or partial response, 4 patients presented complete response, and 1 patient presented disease progression.
  
  
  CONCLUSIONS
  Helical tomotherapy is useful to achieve dose-per-fraction escalation without increasing the treatment-related morbidity. Our results applying dose escalation were encouraging considering that we delivered doses that may be difficult to achieve with 3-dimensional treatments with no excessive complication rates.
authors.affiliation: Department of Radiotherapy, S. Camillo-Forlanini Hospital, Rome, Italy. alessiamonaco@gmail.com
authors.forename: Alessia
authors.initials: A
authors.lastname: Monaco
authors.forename: Cristina
authors.initials: C
authors.lastname: Caruso
authors.forename: Daniela
authors.initials: D
authors.lastname: Giammarino
authors.forename: Michele
authors.initials: M
authors.lastname: Cianciulli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Pressello
authors.forename: Vittorio
authors.initials: V
authors.lastname: Donato
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D004307:Dose-Response Relationship, Radiation; D004947:Esophagus / Q000528:radiation effects*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011832:Radiation Injuries; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome