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.