Clinical Outcome of Helical Tomotherapy for Inoperable Non-Small Cell Lung Cancer: The Kyung Hee University Medical Center Experience

Background: Published studies on clinical outcome of helical tomotherapy for lung cancer are limited. Thepurpose of this study was to evaluate clinical outcomes and treatment-related toxicity in inoperable non-smallcell lung cancer (NSCLC) patients treated with helical tomotherapy in Korea. Materials and
Methods: Twentysevenpatients with NSCLC were included in this retrospective study. Radiotherapy was performed using helicaltomotherapy with a daily dose of 2.1-3 Gy delivered at 5 fractions per week resulting in a total dose of 62.5-69.3Gy. We assessed radiation-related lung and esophageal toxicity, and analyzed overall survival, locoregionalrecurrence-free survival, distant metastasis-free survival, and prognostic factors for overall survival.
Results:The median follow-up period was 28.9 months (range, 10.1-69.4). The median overall survival time was 28.9months, and 1-, 2-, and 3-year overall survival rates were 96.2%, 92.0%, and 60.0%. The median locoregionalrecurrence-free survival time was 24.3 months, and 1-, 2-, and 3-year locoregional recurrence-free survival rateswere 85.2%, 64.5%, and 50.3%. The median distant metastasis-free survival time was 26.7 months, and 1-, 2-,and 3-year distant metastasis-free survival rates were 92.3%, 83.9%, and 65.3%, respectively. Gross tumorvolume was the most significant prognostic factor for overall survival. No grade 4 or more toxicity was observed.
Conclusions: Helical tomotherapy in patients with inoperable NSCLC resulted in high survival rates with anacceptable level of toxicity, suggesting it is an effective treatment option in patients with medically inoperableNSCLC.