Table 3.
Toxicity and survival rates for thoracic neoplasms and NSCLC for retrospective and prospective study designs
| [ref] | Study design | Period of study | N | Prescription- diagnosis and staging | RT technique | Median follow-up | Outcomes- toxicity | Outcomes- survival |
|---|---|---|---|---|---|---|---|---|
| 80 | Retrospective | 09/2015–10/2018 | 27 | 60 Gy/8 F Patient cohort: Central thoracic oligometastases |
SBRT- IMRT or SBRT-VMAT |
11.6 months (IQR 6.5–19.4 months) | No Grade > 3 toxicities Acute Grade II toxicity-3 (11.1%) Grade II dysphagia-one case: 1 month post-SBRT resolved by 3 month Grade II radiation pneumonitis - 2 cases resolved with steroid treatment. Grade 2 late Toxicity - fatigue, One (3.7%) |
1 year IFC 95.2% (95% confidence interval [CI] 86.6–100.0%) 2 year IFC 85.7% (95% CI 68.3–100.0%) 1 year PFS 42.8% (95% CI 26.1–70.1%) 2 year PFS 23.4% (95% CI 9.8–55.9%) 1 year OS 82.7% (95% CI 68.6–99.7%) 2 year OS 69.5% (95% CI 51.0–94.7%) |
| 81 | Retrospective | 03/2011–09/2016 | 134 | 52 Gy/26F or 64 Gy/32F Diagnosis: Stage I-IV NSCLC |
VMAT- 6 MV single arc or two-arc | 18.6 months (range, 2–45 months) |
Radiation pneumonitis
Grade 0–2 (N = 120) Grade 3–4 (N = 14) Fibrosis Grade 0–2 (N = 122) Grade 3–4 (=12) Further toxicity classification seen in Table 2 |
2 year PFS 18.2% median PFS 7.6 months 2 year OS 38.4%, median survival time of 18.6 months |
| 77 | Retrospective | 11/2007-06/2016 | 300 | 48 Gy in 12 Gy × 4 fractions. Diagnosis: Stage I NSCLC T1a: 59% (N = 111) T1b: 30% (N = 57) T2: 11% (N = 21) All patients were N0 and M0. |
2007–2010, Patients treated with (n > 7) coplanar/ non-coplanar beams After 2010, all patients were treated (VMAT) two half arcs |
18 months (IQR: 9–33 months) |
No Grade IV or V toxicity observed Fatigue (41%; N = 77) Chest wall pain (10%; N = 19) Dyspnea (7%; N = 14) Radiation pneumonitis (4%; N = 8, including 2% of Grade 3), Dermatitis(4%;N = 7) Cough (3%;N = 6) Rib fractures (2%; N = 3) Esophagitis (1%; N = 1) |
1 year OS 83% [95% CI; 78–89%] (N = 128) 2 year OS 65% [95% CI: 57–73%](N = 78) 4 years, the OS 37% [95% CI; 29–47%] (N = 53) Median survival 37 months. 1 year DFS 75% [95% CI: 68–81%] (N = 114) 2 year DFS 49% [95% CI: 42–58%] (N = 60) 4 year DFS 31% [95% CI: 24–41%] (N = 41) |
| 6 | Retrospective | 01/2009-03/2017 | 3872 | Diagnosis: Stage III NSCLC | 3DCRT - N = 1178 (30.4%) IMRT N = 1847 (47.7%) VMAT N = 847 (21.9%) |
Not stated | Not assessed | 1 year OS 3CRT Group 74.4% (71.8–76.8); 1 year OS IMRT Group 74.4% (71.8–76.8) 1 year OS VMAT Group 77.5% (74.6–80.2) 5 years OS 3DCRT 22.4% (95% CI, 20.0–25.0) 5 year OS IMRT 23.5% (95% CI, 21.3–25.7) 5 year OS VMAT 23.9% (95% CI, 20.0–28.0) |
| 82 | Non-randomised trial | 2012–2016 | 51 | Not specified newly diagnosed or recurrent Stage II or III NSCLC |
Multifield optimised IMPT plans three or four beams | 23.0 months (range 0.9–60.1 months) | Pneumonitis G1 16% G2 14% Cardiac toxicity G1 6% G2 8% Oesophagitis G1 37% G2 43% G3 6% Radiation dermatitis G1 33% G2 31% G3 6% Pain G1 37% G2 29% Oesophageal stricture G3 2% Fatigue G1 63% G2 27% G3 2% Further analysis refer to Table 4 |
Median OS 33.9 months Median DFS 12.6 months 3 year LC 78.3% 3 year DFFS 51% Further analysis refer to Table 2 |
Terms: 3DCRT, 3D conformal radiotherapy; DFFS, distant failure-free survival; DFS, disease free survival; IFC, in field control; IMRT, intensity modulated radiation therapy; LC, Local control; NSCLC, non-small cell lung cancer; OS, overall survival; PFS, progression-free survival; RT, radiation therapy; SBRT, stereotactic body radiation therapy; VMAT, volumetric modulated arc therapy.