Non-Small Cell Lung Cancer Coverage from Every Angle

Individualized Versus Standard Dosing of Radiotherapy in Stage III NSCLC

By: Sarah Campen, PharmD
Posted: Tuesday, December 22, 2020

In patients with locally advanced non–small cell lung cancer (NSCLC), treatment with individualized adaptive radiotherapy appears to significantly improve overall survival compared with standard radiotherapy, according to the Chinese phase III CRTOG1601 trial presented during the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 219). Shuanghu Yuan, MD, PhD, of Shandong University, Jinan, China, and colleagues reported that the individualized dose-escalation approach was well tolerated, and both treatment arms had a similar safety profile.

In this open-label study, 226 patients with unresectable stage III NSCLC were randomly assigned to receive either standard-dose (60 Gy) or individualized adaptive dose-escalation (≥ 66 Gy) radiotherapy with concurrent and consolidation chemotherapy. A treatment plan was developed for patients in the individualized group based on a baseline CT and PET scan; the scans were repeated after 18 to 20 fractions were delivered. Based on the mid-treatment scan results, dose escalation of 22 to 32 Gy was delivered in 10 fractions to the adaptive target in a second round of treatment.

The median overall survival in the individualized group was significantly better than in the standard group (44.6 vs. 28.0 months, P = .001); progression-free survival was also improved with individualized adaptive radiotherapy (15.1 vs. 11.6 months, P = .001). The objective response rates in the two arms were similar (73.3% vs. 65.3%, P = .192).

Disclosure: The authors reported no conflicts of interest.

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