title: Outcome and toxicity profiles in the treatment of locally advanced lung cancer with volumetric modulated arc therapy.
abstract: OBJECTIVE
  To report about the outcome of radiation treatment of advanced lung cancer patients with volumetric modulated arcs [RapidArc (RA)].
  
  
  METHODS
  Seventy-five consecutive patients (all stages IIIA and IIIB) were treated with RA. Among them 71 % were men; 25.4 % presented unspecified non-small cell lung cancer, 41.3% adenocarcinoma and 33.3 % squamous cell carcinoma. Of them, 54.7 % received sequential chemotherapy while 45.3% were treated with concomitant regimen. Dose prescription ranged from 54 to 72 Gy. Analysis included survival, local control (LC) and toxicity profiles.
  
  
  RESULTS
  Median follow-up was 21.2 months (range 6-75). One- two- and five-year actuarial LC was 91.9 ± 3.2, 79.5 ± 5.7 and 67.4 ± 9.5 %, respectively. Median survival was 19.0 ± 1.1 months. Actuarial survival at 1-2-5 years was 80.0 ± 4.6, 38.5 ± 5.9 and 15.2 ± 4.9 %, respectively. Acute toxicity of G2 was reported in 24, 25.3 and 4.0 % of patients for lung, esophageal and hematological profiles. A total of 2.7 % of patients reported G3 toxicity in the esophagus and 5.3 % of the patients experienced G3-G4 hematological toxicity. Significant differences were observed in all cases between concomitant and sequential chemotherapy regiments. Only 1.3 % (1 patient) showed G2 lung late toxicity. No significant correlation was found between toxicity and organ's irradiation levels.
  
  
  CONCLUSIONS
  RA proved to be a safe and advantageous treatment modality for advanced lung cancer with results in line with expectations from earlier literature.
authors.affiliation: Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, MI, Italy, piera.navarria@humanitas.it.
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
authors.forename: Piera
authors.initials: P
authors.lastname: Navarria
authors.forename: Fiorenza
authors.initials: F
authors.lastname: De Rose
authors.forename: AnnaMaria
authors.initials: A
authors.lastname: Ascolese
authors.forename: Elena
authors.initials: E
authors.lastname: Clerici
authors.forename: Ciro
authors.initials: C
authors.lastname: Franzese
authors.forename: Francesca
authors.initials: F
authors.lastname: Lobefalo
authors.forename: Giacomo
authors.initials: G
authors.lastname: Reggiori
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.forename: Stefano
authors.initials: S
authors.lastname: Tomatis
authors.forename: Antonella
authors.initials: A
authors.lastname: Fogliata
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology; D011832:Radiation Injuries / Q000209:etiology*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D016896:Treatment Outcome