Schild Steven E, Wong William W, Vora Sujay A, Halyard Michele Y, Northfelt Donald W, Kogut Heidi L, Wheeler Richard H
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA.
Int J Radiat Oncol Biol Phys. 2005 Aug 1;62(5):1432-7. doi: 10.1016/j.ijrobp.2005.01.003.
This analysis was performed to determine the long-term results of a Phase I trial that included 3-times-a-day radiotherapy (TIDRT) and concurrent daily cisplatin (CDDP) for Stage III non-small-cell lung cancer.
Twenty patients with Stage III non-small-cell lung cancer were treated with TIDRT delivered over 12 weekdays that included 57.6 Gy administered in 1.5 Gy fractions at 8 a.m. and 4 p.m., and 1.8 Gy fractions at noon. AP-PA fields were used at 8 a.m. and 4 p.m. Opposed oblique off cord fields were used at noon. The first 5 patients were given no CDDP, the second 5 patients received 5 mg/m2 of CDDP, and the remaining 10 patients received 7.5 mg/m2 of CDDP. All survivors were followed for greater than 5 years.
The maximum tolerated dose of daily CDDP during this program of radiation therapy was 7.5 mg/m2. None of the patients died as a result of toxicity. The median survival was 19.2 months, and the 5-year survival rate was 25%. Tumor response and patterns of failure were also evaluated.
This study was performed to determine the maximum tolerated dose of CDDP when administered daily during an aggressive program of TIDRT. The survival results were promising, suggesting that the combination of TIDRT and systemic therapy deserves further study.
进行此项分析以确定一项I期试验的长期结果，该试验包括对III期非小细胞肺癌采用每日3次放疗（TIDRT）及同步每日给予顺铂（CDDP）。
20例III期非小细胞肺癌患者接受TIDRT治疗，疗程为12个工作日，包括上午8点和下午4点以1.5 Gy分割给予57.6 Gy，中午以1.8 Gy分割给予。上午8点和下午4点使用前后对穿野。中午使用对穿斜野避开脊髓。前5例患者未给予顺铂，接下来的5例患者接受5 mg/m²的顺铂，其余10例患者接受7.5 mg/m²的顺铂。所有存活者均随访超过5年。
在此放疗方案期间，每日顺铂的最大耐受剂量为7.5 mg/m²。无患者因毒性死亡。中位生存期为19.2个月，5年生存率为25%。还评估了肿瘤反应及失败模式。
本研究旨在确定在积极的TIDRT方案中每日给予顺铂时的最大耐受剂量。生存结果令人鼓舞，表明TIDRT与全身治疗的联合值得进一步研究。
