Abstract
MATERIALS AND METHODS
15 patients with stage III non-small cell lung cancer (NSCLC) with a peripheral primary tumor < 5 cm were prospectively included and treated with concurrent daily low-dose chemoradiation using a hybrid fractionation schedule of simultaneous 24 fractions conventionally fractionated radiotherapy and 3 fractions SBRT. The allowed mean lung dose (MLD) was escalated by adapting the SBRT fraction dose between 14 and 18 Gy per fraction using the time-to-event continual reassessment method (TITE-CRM).
CONCLUSION
Simultaneous SBRT to the primary tumor and fractionated radiotherapy to the lymph nodes is feasible and safe with concurrent daily dose cisplatin with high loco-regional control rates.
RESULTS
All patients were able to be planned and treated per protocol. No dose-limiting toxicity was observed with a maximum treated MLD of 19.1 Gy. The most common Grade 1-2 toxicities consisted of radiation pneumonitis (N = 7) or rib fractures (N = 6). No G3+ pulmonary or mediastinal toxicities were observed. Although local and regional control were excellent (both 93%), 11 patients (73%) eventually developed progressive disease at distant sites at a median of 11 months.
PURPOSE
The phase I Hybrid trial assessed the safety of combining simultaneous stereotactic body radiotherapy (SBRT) to the primary tumor and fractionated radiotherapy to the lymph nodes with concurrent cisplatin.