International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 5 , Pages 1391-1396 , 1 April 2009

Does Incidental Irradiation With Doses Below 50 Gy Effectively Reduce Isolated Nodal Failures in Non–Small-Cell Lung Cancer: Dose–Response Relationship

  • Lucyna Kepka, M.D., Ph.D.

      Affiliations

    • Department of Radiotherapy, Cancer Center, Maria Sklodowska-Curie Memorial Institute, Warsaw, Poland
    • ,
  • BogusŁaw Maciejewski, M.D., Ph.D., F.A.C.R.

      Affiliations

    • Department of Radiotherapy, Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Gliwice, Poland
    • Corresponding Author InformationReprint requests to: Bogusław Maciejewski, M.D., Department of Radiotherapy, Cancer Centre, Maria Sklodowska-Curie Memorial Institute, Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland. Tel: (+48) 32-231-54-87; Fax: (+48) 32-230-78-07
    • ,
  • Rodney H. Withers, M.D., D.Sc.

      Affiliations

    • Department of Radiation Oncology, University of California, Los Angeles Medical Center, Los Angeles, CA

Received 12 April 2008 ,Accepted 7 July 2008.

References 

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  2. Withers HR, Peters LJ, Taylor JMG. Dose response relationship for radiation therapy of subclinical disease. Int J Radiat Oncol Biol Phys. 1995;31:353–359
  3. Withers HR, Suwinski R. Radiation dose response for subclinical metastases. Semin Radiat Oncol. 1998;8:224–228
  4. Jeremic B. Incidental irradiation of nodal regions at risk during limited-field radiotherapy (RT) in dose-escalation studies in nonsmall cell lung cancer (NSCLC). Enough to convert no-elective into elective nodal irradiation (ENI)?. Radiother Oncol. 2004;71:123–125
  5. Kepka L, Bujko K, Zolciak-Siwinska A. Risk of isolated nodal failure for non-small cell lung cancer (NSCLC) treated with the elective nodal irradiation (ENI) using 3-D conformal radiotherapy (3D-CRT) techniques. Acta Oncol. 2008;47:95–103
  6. Kepka L, Fijuth J, Bujko K, et al. Conformal radiotherapy for non-small cell lung cancer (NSCLC) to the dose of 70-74 Gy with or without elective nodal irradiation (ENI). Results and patterns of failures. Nowotwory J Oncol. 2004;54:342–346
  7. Kepka L, Fijuth J, Zawadzka A, et al. Accelerated radiotherapy for locally advanced NSCLC: Significance of bulky disease?. Radiother Oncol. 2002;64:S254
  8. Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest. 1997;111:1718–1123
  9. Chapet O, Kong FM, Quint LE, et al. CF based definition of thoracic lymph node stations: An atlas from the University of Michigan. Int J Radiat Oncol Biol Phys. 2005;63:170–178
  10. Rosenzweig KE, Sim SE, Michalczak B, et al. Elective nodal irradiation in the treatment of non-small-cell lung cancer with three-dimensional conformal radiation therapy. Int J Radiat Oncol Biol Phys. 2001;50:681–685
  11. Chen MC, Hayman JA, Ten Haken RK, et al. Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T1-3N0 non small-cell lung cancer: Is low incidence of regional failure due to incidental nodal irradiation?. Int J Radiat Oncol Biol Phys. 2006;64:120–126
  12. Emami B, Mirkovic N, Scott C, et al. The impact of regional nodal radiotherapy (dose/volume) on regional progression and survival in unresectable non-small cell lung cancer: An analysis of RTOG data. Lung Cancer. 2003;41:207–214
  13. Senan S, Burgers S, Samson MJ, et al. Can elective nodal irradiation be omitted in stage III non-small-cell lung cancer? Analysis of recurrences in a phase II study of induction chemotherapy and involved-field radiotherapy. Int J Radiat Oncol Biol Phys. 2002;54:999–1006
  14. Rosenzweig KE, Sura S, Jackson A, et al. Involved-field radiation therapy for inoperable non-small cell lung cancer. J Clin Oncol. 2007;35:5557–5561
  15. Jeremic B. Low incidence of isolated nodal failures after involved-field radiation therapy for non-small-cell lung cancer: Blinded by the light?. J Clin Oncol. 2007;35:5543–5545

 Conflict of interest: none.

PII: S0360-3016(08)03794-2

doi: 10.1016/j.ijrobp.2008.07.070

International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 5 , Pages 1391-1396 , 1 April 2009

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