Late complications of high-dose (>/=66 Gy) thoracic conformal radiation therapy in combined modality trials in unresectable XXXX .

@entity1 @entity82 @entity137 @entity5 @entity1207 @entity358 @entity850
BACKGROUND: Combined modality treatment is the standard of care for @entity1 (pts) with unresectable @entity5 . Dose escalation of radiotherapy is one strategy used to improve locoregional control and survival, but it increases the risk of both early and late treatment related @entity137 . METHODS: From May 1996 to August 2004, a total of 112 @entity5 pts were treated on 4 phase I/II or phase II trials to assess the safety and feasibility of high-dose (60-90 Gy) thoracic conformal radiotherapy. @entity1 who received >/=66 Gy (n = 88) were included in an analysis of late complications. Late complications were defined as complications that developed or persisted >/=90 days postradiotherapy. The classic lung @entity137 of @entity1207 and @entity82 were not included in this analysis. RESULTS: Of the 88 @entity1 included in this analysis of late complications, 21 @entity1 (24%) developed a late complication and a total of 28 late complications were observed. The late complications were: pulmonary (n = 5; @entity850 [n = 3] and fatal @entity358 [n = 2]), esophageal (n = 6), cardiac (n = 9), osseous (n = 6), and second @entity5 (n = 2). The median survival for all @entity1 enrolled on the 4 trials (with 95% confidence interval [CI]) was 24.7 months (18.1-30.4 months), and the 5-year overall survival (with 95% CI) was 24% (16-32%). Data to assess for radiographic evidence of local progression were available for 99 @entity1 , and the rate of local progression was 43% (95% CI 34-53%). CONCLUSIONS: High-dose thoracic conformal radiotherapy is feasible and results in promising survival outcomes. Late complications occur in a minority of @entity1 .
