Menu
Menu
19 Harley St, London, W1G 9QJ, UK

Dose escalation to 84 Gy with concurrent chemotherapy in stage III NSCLC seems excessively poisonous: Outcomes from a prematurely terminated randomized section II trial.

Related Articles

Dose escalation to 84 Gy with concurrent chemotherapy in stage III NSCLC seems excessively poisonous: Outcomes from a prematurely terminated randomized section II trial.

Lung Most cancers. 2018 Aug;122:180-186

Authors: Hallqvist A, Bergström S, Björkestrand H, Svärd AM, Ekman S, Lundin E, Holmberg E, Johansson M, Friesland S, Nyman J

Summary
OBJECTIVES: Concurrent chemoradiotherapy is the mainstay remedy for NSCLC stage III illness. To analyze whether or not radiation dose escalation based mostly on particular person regular tissue constraints can enhance consequence, the Swedish lung most cancers examine group launched this randomized section II trial.
MATERIALS AND METHODS: NSCLC sufferers with stage III illness, good efficiency standing (Zero-1) and satisfactory lung perform (FEV1?>?1.Zero?L and CO diffusion capability > 40%) acquired three cycles of cisplatin (75?mg/m2 day 1) and vinorelbine (25?mg/m2 day 1 and eight) each third week. Radiotherapy began concurrently with the second cycle, with both 2?Gy every day, 5 days per week, to 68?Gy (A) or escalated remedy (B) based mostly on constraints to the spinal twine, esophagus and lungs as much as 84?Gy by including an additional fraction of two?Gy per week.
RESULTS: A pre-planned security evaluation revealed extreme toxicity and decreased survival within the escalated arm, and the examine was stopped. Thirty-six sufferers have been included throughout 2011-2013 (56% male, 78% with adenocarcinoma, 64% with PS Zero and 53% with stage IIIB). The median progression-free survival (PFS) and total survival (OS) have been 11 and 17 months in arm B in comparison with the encouraging outcomes of 28 and 45 months in the usual arm. The 1- and Three-year survival charges have been 56% and 33% (B) and 72% and 56% (A), respectively. There have been seven toxicity-related deaths as a result of esophageal perforations and pneumonitis: 5 within the escalated group and two with customary remedy.
CONCLUSION: Dose-escalated concurrent chemoradiotherapy to 84?Gy to major tumor and nodal illness is hazardous, with a excessive danger of extreme toxicity, whereas fashionable customary dose chemoradiotherapy with correct staging given within the management arm exhibits a promising consequence with a median survival of 45 months and a Three-year survival of 56% (NCT01664663).

PMID: 30032828 [PubMed – in process]

Related Articles Dose escalation to 84 Gy with concurrent chemotherapy in stage III NSCLC appears excessively toxic: Results from a prematurely terminated randomized phase II trial. Lung Cancer. 2018 Aug;122:180-186 ...

What our patients say ...

Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Anaesthetist

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

Laser Spine Surgery Articles

SHADES of grey – The challenge of ‘grumbling’ cauda equina symptoms in older adults with lumbar spinal stenosis.
Abstract Diagnosing cauda equina syndrome is challenging in older adults with lumbar spinal stenosis. Understanding these challenges is vital for
Read more.
The influence of preoperative mental health on clinical outcomes after laminectomy in patients with lumbar spinal stenosis.
Abstract OBJECTIVE: The influence of preoperative mental health on health-related quality of life (HRQOL) in patients with lumbar spinal stenosis
Read more.
MicroRNA transcriptome analysis on hypertrophy of ligamentum flavum in patients with lumbar spinal stenosis.
Abstract Introduction: Molecular pathways involved in ligamentum flavum (LF) hypertrophy are still unclarified. The purpose of this study was to
Read more.
Salvage Strategy for Failed Spinal Fusion Surgery Using Lumbar Lateral Interbody Fusion technique: A Technical Note.
Abstract Introduction: Failed spinal fusion surgery sometimes requires salvage surgery when symptomatic, especially with postsurgical decrease in intervertebral disc height
Read more.
Integrated anatomy of the neuromuscular, visceral, vascular, and urinary tissues determined by MRI for a surgical approach to lateral lumbar
Abstract Introduction: To comprehensively investigate the anatomy of the neuromuscular, visceral, vascular, and urinary tissues and their general influence on
Read more.
Clinical Outcomes of Treating Cervical Adjacent Segment Disease by Anterior Cervical Discectomy and Fusion Versus Total Disc Replacement: A Systematic
Related Articles Clinical Outcomes of Treating Cervical Adjacent Segment Disease by Anterior Cervical Discectomy and Fusion Versus Total Disc Replacement:
Read more.

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810