Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab

Iris Walraven; Michel van den Heuvel; Judi van Diessen; Eva Schaake; Wilma Uyterlinde; Joachim Aerts; Frederieke Koppe; Henk Codrington; Peter Kunst; Edith Dieleman; Paul van de Vaart; Marcel Verheij; Jose Belderbos

doi:10.1016/j.radonc.2016.02.011

Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab

Iris Walraven, Michel van den Heuvel, Judi van Diessen, Eva Schaake, Wilma Uyterlinde, Joachim Aerts, Frederieke Koppe, Henk Codrington, Peter Kunst, Edith Dieleman, Paul van de Vaart, Marcel Verheij, Jose Belderbos

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND PURPOSE: Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy.

MATERIALS AND METHODS: A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated.

RESULTS: Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS.

DISCUSSION: In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.

Original language	English
Pages (from-to)	442-6
Number of pages	5
Journal	Radiotherapy and Oncology
Volume	118
Issue number	3
DOIs	https://doi.org/10.1016/j.radonc.2016.02.011
Publication status	Published - Mar 2016

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10.1016/j.radonc.2016.02.011

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Walraven, I., van den Heuvel, M., van Diessen, J., Schaake, E., Uyterlinde, W., Aerts, J., Koppe, F., Codrington, H., Kunst, P., Dieleman, E., van de Vaart, P., Verheij, M., & Belderbos, J. (2016). Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab. Radiotherapy and Oncology, 118(3), 442-6. https://doi.org/10.1016/j.radonc.2016.02.011

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title = "Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab",

abstract = "BACKGROUND AND PURPOSE: Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy.MATERIALS AND METHODS: A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated.RESULTS: Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS.DISCUSSION: In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.",

keywords = "Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Cetuximab, Chemoradiotherapy, Cisplatin, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Lung Neoplasms, Male, Middle Aged, Positron-Emission Tomography, Survival Rate, Treatment Outcome, Clinical Trial, Phase II, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't",

author = "Iris Walraven and {van den Heuvel}, Michel and {van Diessen}, Judi and Eva Schaake and Wilma Uyterlinde and Joachim Aerts and Frederieke Koppe and Henk Codrington and Peter Kunst and Edith Dieleman and {van de Vaart}, Paul and Marcel Verheij and Jose Belderbos",

year = "2016",

month = mar,

doi = "10.1016/j.radonc.2016.02.011",

language = "English",

volume = "118",

pages = "442--6",

journal = "Radiotherapy and Oncology",

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Walraven, I, van den Heuvel, M, van Diessen, J, Schaake, E, Uyterlinde, W, Aerts, J, Koppe, F, Codrington, H, Kunst, P, Dieleman, E, van de Vaart, P, Verheij, M & Belderbos, J 2016, 'Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab', Radiotherapy and Oncology, vol. 118, no. 3, pp. 442-6. https://doi.org/10.1016/j.radonc.2016.02.011

Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab. / Walraven, Iris; van den Heuvel, Michel; van Diessen, Judi et al.
In: Radiotherapy and Oncology, Vol. 118, No. 3, 03.2016, p. 442-6.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab

AU - Walraven, Iris

AU - van den Heuvel, Michel

AU - van Diessen, Judi

AU - Schaake, Eva

AU - Uyterlinde, Wilma

AU - Aerts, Joachim

AU - Koppe, Frederieke

AU - Codrington, Henk

AU - Kunst, Peter

AU - Dieleman, Edith

AU - van de Vaart, Paul

AU - Verheij, Marcel

AU - Belderbos, Jose

PY - 2016/3

Y1 - 2016/3

N2 - BACKGROUND AND PURPOSE: Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy.MATERIALS AND METHODS: A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated.RESULTS: Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS.DISCUSSION: In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.

AB - BACKGROUND AND PURPOSE: Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy.MATERIALS AND METHODS: A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated.RESULTS: Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS.DISCUSSION: In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Carcinoma, Non-Small-Cell Lung

KW - Cetuximab

KW - Chemoradiotherapy

KW - Cisplatin

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Kaplan-Meier Estimate

KW - Lung Neoplasms

KW - Male

KW - Middle Aged

KW - Positron-Emission Tomography

KW - Survival Rate

KW - Treatment Outcome

KW - Clinical Trial, Phase II

KW - Journal Article

KW - Multicenter Study

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.radonc.2016.02.011

DO - 10.1016/j.radonc.2016.02.011

M3 - Article

C2 - 26900091

SN - 0167-8140

VL - 118

SP - 442

EP - 446

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

IS - 3

ER -