Outcome and toxicity profiles in the treatment of locally advanced lung cancer with volumetric modulated arc therapy.

PURPOSE: To report about the outcome of radiation treatment of advanced lung cancer patients with volumetric modulated arcs [RapidArc (RA)].

PATIENTS AND

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.

CONCLUSION

RA proved to be a safe and advantageous treatment modality for advanced lung cancer with results in line with expectations from earlier literature.