Intensity-modulated radiation therapy with concurrent chemotherapy followed by durvalumab for stage III non-small cell lung cancer: A multi-center retrospective study

Yoko Tsukita, Takaya Yamamoto, Hiroshi Mayahara, Akito Hata, Yuichiro Takeda, Hidetsugu Nakayama, Satoshi Tanaka, Junji Uchida, Kazuhiro Usui, Tatsuya Toyoda, Motohiro Tamiya, Masahiro Morimoto, Yuko Oya, Takeshi Kodaira, Eisaku Miyauchi, Keiichi Jingu, Hisatoshi Sugiura

研究成果: ジャーナルへの寄稿学術論文査読

24 被引用数 (Scopus)

抄録

Background and purpose: Intensity-modulated radiation therapy (IMRT) is increasingly applied in concurrent chemoradiotherapy (CCRT) for locally-advanced non-small cell lung cancer (NSCLC), with improvement of target coverage and better sparing of normal tissue. IMRT tends to have a larger low-dose irradiation volume than 3D conformal radiotherapy, but the incidence of and risk factors for pneumonitis remain unclear, especially following the approval of durvalumab. Materials and methods: We retrospectively reviewed the records of NSCLC patients treated by CCRT using IMRT at seven Japanese institutions. Primary outcomes were incidence of symptomatic pneumonitis and progression-free survival (PFS). Multivariate logistic regression analysis was used to identify risk factors for ≥grade 2 pneumonitis. Results: Median follow-up from the start of CCRT was 14.3 months (n = 107 patients; median age 70 years, 29% female). Median lung V5 and V20 was 49.2% and 19.5%, respectively. Durvalumab was administered to 87 patients (81%). Pneumonitis developed in 95 (89%) patients of which 53% had grade 1, 28% grade 2, 6.5% grade 3, and 0.9% grade 4. Durvalumab had been discontinued in 16 patients (18.4%) due to pneumonitis. By multivariate analysis, age ≥70 years, male sex, and V5 ≥58.9% were identified as significantly associated with ≥grade 2 pneumonitis (p = 0.0065, 0.036 and 0.0013 respectively). The median PFS from the start of CCRT was not reached (95% CI, 14.2 months to not reached) in patients receiving durvalumab. Conclusion: CCRT using IMRT followed by durvalumab was generally effective and tolerable; V5 <60% would be recommended to avoid symptomatic pneumonitis.

本文言語英語
ページ(範囲)266-272
ページ数7
ジャーナルRadiotherapy and Oncology
160
DOI
出版ステータス出版済み - 07-2021
外部発表はい

All Science Journal Classification (ASJC) codes

  • 血液学
  • 腫瘍学
  • 放射線学、核医学およびイメージング

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