Photo Credit: Dr Microbe

Intensity-modulated radiotherapy (IMRT) is recommended for locally advanced NSCLC and appears to have good long-term outcomes, according to a study published in JAMA Oncology. Stephen G. Chun, MD, and colleagues compared long-term prospective outcomes of patients receiving IMRT and three-dimensional conformal radiotherapy (3D-CRT) with concurrent chemotherapy in a phase 3 randomized trial involving 483 patients with locally advanced NSCLC. Of the total cohort, 228 and 255 received IMRT and 3D-CRT, respectively. The percentage of an organ volume (V) receiving a specified dose of radiation in units of Gy was reported as V(radiation dose). Compared with 3D-CRT, IMRT was significantly associated with a twofold reduction in grade 3 or higher pneumonitis AEs (3.5% vs 8.2%). In a univariate analysis, Heart V20, V40, and V60 were associated with worse overall survival. Significantly reduced heart V40 was seen with IMRT versus 3D-CRT (16.5 % vs 20.5%). The researchers observed significantly better OS with heart V40 (<20%) versus V40 (≥20%; median, 2.5 vs 1.7 years). Heart V40 (≥20%) was associated with worse OS in a multivariable analysis, while there was no association between lung V5 and age.