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- Title
Intensity-Modulated Radiation Therapy May Improve Local-Regional Tumor Control for Locally Advanced Non-Small Cell Lung Cancer Compared With Three-Dimensional Conformal Radiation Therapy.
- Authors
Wang, Jingbo; Zhou, Zongmei; Liang, Jun; Feng, Qinfu; Xiao, Zefen; Hui, Zhouguang; Wang, Xiaozhen; Lv, Jima; Chen, Dongfu; Zhang, Hongxing; Ji, Zhe; Cao, Jianzhong; Liu, Lipin; Jiang, Wei; Men, Yu; Xu, Cai; Dai, Jiangrong; Yin, Weibo; Wang, Luhua
- Abstract
Background. Consistent results are lacking as regards the comparative effectiveness of intensity-modulated radiotherapy (IMRT) versus three-dimensional conformal radiotherapy (3DCRT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). Patients and Methods. Patients treated with definitive radiotherapy (RT) between 2002 and 2010 were retrospectively reviewed. Overall survival (OS), local-regional progression-free survival (LRPFS), distant metastasis-free survival (DMFS), and progression-free survival (PFS) were compared among patients irradiated with different techniques. The association between RT technique and survival indexes was assessed in a Cox proportional hazard regression model. Propensity score matching (PSM) was used to balance known confounding factors. Results. A total of 652 patients were eligible for analysis, including 206 with 3DCRT and 446 with IMRT. The median OS of the 3DCRTand IMRT groups were 19.4 and 23.3 months, with the 5-year rate of 13% and 19%, respectively (p 5 .043).Multivariate analysis identified IMRT as an independent favorable factor associated with LRPFS and DMFS. PSM analysis further verified the beneficial effect of IMRTon LRPFS. No difference in OS or PFS was observed between the two techniques. Subgroup analysis revealed that IMRTmight be differentially more effective in both OS and LRPFS among patients who were female, nonsmokers, with adenocarcinoma, or without weight loss. There was a significant reduction of lung toxicity and similar esophagus toxicity in the IMRTgroup when compared with the 3DCRTgroup. Conclusion. IMRT may confer superior LRPFS and comparable OS than can be achieved with 3DCRT in LA-NSCLC, along with the reduction of pulmonary toxicity.
- Subjects
CHI-squared test; COMBINED modality therapy; COMPARATIVE studies; CONFIDENCE intervals; LONGITUDINAL method; LUNG cancer; MULTIVARIATE analysis; PROBABILITY theory; RADIATION doses; RADIOTHERAPY; REGRESSION analysis; RESEARCH funding; SURVIVAL analysis (Biometry); MATHEMATICAL variables; WEIGHT loss; TREATMENT effectiveness; PROPORTIONAL hazards models; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; LOG-rank test; MANN Whitney U Test
- Publication
Oncologist, 2016, Vol 21, Issue 12, p1530
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2016-0155