Higher Doses of Image-Guided Neoadjuvant Radiation Therapy Found to Be Safe in Locally Advanced NSCLC: Study
A retrospective study suggested that 60 Gy of neoadjuvant concomitant image-guided radiotherapy is safe and effective in locally advanced NSCLC.
|The following article features coverage from the International Association for the Study of Lung Cancer (IASLC) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.|
Neoadjuvant concomitant chemoradiation (NACCRT) of 60 Gy was safe and induced antitumor responses in patients with locally advanced non-small cell lung cancer (LANSCLC), according to a retrospective study presented at the IASLC's 19th World Conference on Lung Cancer in Toronto, Canada.1
The typical intensity of NACCRT is 45 Gy, but previous studies have suggested that higher doses are safe. The aim of this study was to evaluate the pathologic response to 60 Gy of NACCRT in LANSCLC.
The retrospective cohort included 70 patients who had undergone NACCRT after surgery between 2012 and 2017. The mean age of patients was 63; 70% were male; 69% were current smokers; and 14.7% were past smokers. Most patients included in the study (60%) had adenocarcinoma, followed by squamous or other histology; 78% of patients had stage 2 disease and 21% were at stage 3. Nearly all patients received platinum-based doublet chemotherapy.
Image-guided radiation was delivered with a mean dose of 59 Gy (range, 46-72 Gy). Surgical resection included lobectomy, chest wall resection, or pneumonectomy, and 90% of patients achieved negative surgical margins.
Major tumor regression (MTR) occurred in 64% of patients, including pathologic complete response in 36%. The mean and median percent of residual tumor cells was 16% and 6.5%, respectively, and approximately 29% of patients harbored less than 10% residual tumor.
According to the investigators, these results suggest that “NACCRT delivered to 60 Gy with modern image-guided radiation therapy is safe.”
Read more of Cancer Therapy Advisor's coverage of the IASLC 2018 meeting by visiting the conference page.
- Appel S, Bar J, Urban D, et al. The pathologic response of locally advanced NSCLC treated with concomitant chemoradiation to 60 Gy in image guided radiation therapy (IGRT). Presented at: International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer; September 23-26, 2018; Toronto, Canada. Abstract MA05.10.