Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer

Jin, Xiance; Lin, Baochai; Chen, Didi; Li, Lili; Han, Ce; Zhou, Yongqiang; Zheng, Xiaomin; Gong, Changfei; Chen, Mengfeng; Xie, Congying

doi:10.7150/jca.31260

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J Cancer 2019; 10(13):2868-2873. doi:10.7150/jca.31260 This issue Cite

Research Paper

Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer

Xiance Jin^1*, Baochai Lin^1*, Didi Chen^1*, Lili Li¹, Ce Han¹, Yongqiang Zhou¹, Xiaomin Zheng¹, Changfei Gong¹, Mengfeng Chen², Congying Xie^1✉

1. Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000,
2. Respiratory Department, Third People's Hospital of Yueqing, Wenzhou, China, 325600
^*authors contribute equally

Citation:

Jin X, Lin B, Chen D, Li L, Han C, Zhou Y, Zheng X, Gong C, Chen M, Xie C. Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer. J Cancer 2019; 10(13):2868-2873. doi:10.7150/jca.31260. https://www.jcancer.org/v10p2868.htm

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Abstract

Background: Published data on the effects and toxicities of volumetric modulated arc therapy (VMAT) in the management of inoperable lung cancer are scarce.

Materials and methods: The clinical outcomes and pulmonary toxicities of 134 patients with consecutive inoperable lung cancer who underwent VMAT from March 2011 to September 2016 were retrospectively reviewed. The dosimetric and characteristic factors associated with acute radiation pneumonitis (RP) and pulmonary fibrosis were evaluated with univariate and multivariate analysis.

Results: The average prescription doses to these 134 patients were 57.07±6.27 Gy (range 52-64 Gy). The overall median follow-up time was 18.6 months (range, 2-45 mo), with a median follow-up time for the surviving patients of 20 months (range, 7-45 mo). The 2-year progression-free survival (PFS) and overall survival (OS) for all patients were 18.2% and 38.4%, with a median PFS and OS of 7.6 months and 18.6 months, respectively. The percent of patients with grade III/higher RP and pulmonary fibrosis were 10.5% and 9.0%, respectively. V13 (p=0.02) and age (p=0.02) were independently associated with acute RP according to multivariate analysis. The constraints for lung dosimetric metrics V10,V13,V20 and V30 were approximately 49%,41%,26% and 17% in VMAT treatment of lung cancer to limit the RP rate < 10%.

Conclusion: VMAT can be delivered safely with acceptable acute and late toxicities for lung cancer patients. Lung dosimetric metrics were valuable in predicting acute RP. A lung V13 constraint of 40% was helpful to limit the RP rate < 10% in VMAT treatment of lung cancer patients.

Keywords: Lung cancer, Volumetric modulated arc therapy, Radiation pneumonitis, Disease free survival, Overall survival

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APA

Jin, X., Lin, B., Chen, D., Li, L., Han, C., Zhou, Y., Zheng, X., Gong, C., Chen, M., Xie, C. (2019). Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer. Journal of Cancer, 10(13), 2868-2873. https://doi.org/10.7150/jca.31260.

ACS

Jin, X.; Lin, B.; Chen, D.; Li, L.; Han, C.; Zhou, Y.; Zheng, X.; Gong, C.; Chen, M.; Xie, C. Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer. J. Cancer 2019, 10 (13), 2868-2873. DOI: 10.7150/jca.31260.

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CSE

Jin X, Lin B, Chen D, Li L, Han C, Zhou Y, Zheng X, Gong C, Chen M, Xie C. 2019. Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer. J Cancer. 10(13):2868-2873.

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