Radiat Oncol J.  2017 Jun;35(2):180-184. 10.3857/roj.2017.00129.

Moderate hypofractionated image-guided thoracic radiotherapy for locally advanced node-positive non-small cell lung cancer patients with very limited lung function: a case report

• Manapov F
• Roengvoraphoj O
• Li M
• Eze C

• KMID: 2386216
• DOI: http://doi.org/10.3857/roj.2017.00129

Abstract

Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second [FEV1] ≤ 1 L) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/ CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function (FEV1 ≤ 1 L).

Keyword

Hypofractionated radiotherapy; Image-guided radiotherapy; NSCLC; Thoracic radiotherapy

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Electrons
Four-Dimensional Computed Tomography
Humans
Induction Chemotherapy
Lung Neoplasms
Lung*
Lymph Nodes
Palliative Care
Prognosis
Radiotherapy*
Radiotherapy, Image-Guided
Tumor Burden