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Comparative Study
. 2019 Jun 13;14(1):106.
doi: 10.1186/s13014-019-1259-3.

Comparison of efficacy and safety between simultaneous integrated boost intensity-modulated radiotherapy and conventional intensity-modulated radiotherapy in locally advanced non-small-cell lung cancer: a retrospective study

Daquan Wang  1 , Nan Bi  1 , Tao Zhang  1 , Zongmei Zhou  1 , Zefen Xiao  1 , Jun Liang  1 , Dongfu Chen  1 , Zhouguang Hui  1 , Jima Lv  1 , Xiaozhen Wang  1 , Xin Wang  1 , Lei Deng  1 , Wenqing Wang  1 , Jingbo Wang  1 , Chunyu Wang  1 , Xiaotong Lu  1 , Kunpeng Xu  1 , Linfang Wu  1 , Wenji Xue  1 , Qinfu Feng  2 , Luhua Wang  3
Affiliations
Comparative Study

Comparison of efficacy and safety between simultaneous integrated boost intensity-modulated radiotherapy and conventional intensity-modulated radiotherapy in locally advanced non-small-cell lung cancer: a retrospective study

Daquan Wang et al. Radiat Oncol. .

Abstract

Background: Consistent results are lacking as regards the comparative effectiveness of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) versus conventional intensity-modulated radiotherapy in patients with locally advanced non-small-cell lung cancer (LA-NSCLC). Therefore, we conducted a retrospective analysis to demonstrate the role of SIB-IMRT for patients.

Methods: Patients who had histologically confirmed NSCLC, stage III disease and received thoracic IMRT between 2014 and 2016 were retrospectively reviewed. The survival, toxicities and dose to organs at risk (OAR) were compared among patients irradiated with different techniques. The SIB-IMRT plans were designed to deliver 45-59.4Gy (median: 50.4Gy) to PTV while simultaneously delivering 50-70Gy (median: 59.92Gy) to PGTV. As for conventional IMRT plans, a total dose of 50-70Gy (median: 60Gy) was delivered to PTV.

Results: 426 patients with stage III NSCLC were eligible for analysis, including 128 with SIB-IMRT and 298 with conventional IMRT. The SIB-IMRT group had more stage IIIB disease (69.5% vs. 53%, P = 0.002), larger planning treatment volumes (median: 504 ml vs. 402 ml, P<0.001), and a larger planning treatment volume/volume of lung ratio (median, 0.18 vs. 0.12, P<0.001). The median OS of the SIB-IMRT and conventional IMRT groups were 34.5 and 31.7 months, with the 2-year rate of 60.4 and 59%, respectively (P = 0.797). No difference in PFS, LRFS or DMFS was observed between the two techniques. Patients treated with SIB-IMRT got similar lung and esophageal toxicities versus those with conventional IMRT.

Conclusions: SIB-IMRT may be an effective and safe option for patients with locally advanced NSCLC, especially for those with large mass or wide lymph node metastasis.

Keywords: Intensity-modulated radiotherapy; Non-small cell lung cancer; Simultaneous integrated boost; Survival; Toxicity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The procedure of data analysis
Fig. 2
Fig. 2
Dose distributions of IMRT plan with SIB technique. (PGTV: 59.92Gy/2.14Gy/28f, PTV 50.4Gy/1.8Gy/28f)
Fig. 3
Fig. 3
Comparison of survival between SIB-IMRT and conventional IMRT in patients. a Overall survival, b Progression-free survival, c Locoregional-recurrence free survival, d Distant-metastasis free survival
See this image and copyright information in PMC

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