Yuan Liao

Publications (2)4.11 Total impact

• Article: Three-dimensional conformal radiation therapy for non-small-cell lung cancer: a phase I/II dose escalation clinical trial.

  Kai-Liang Wu, Guo-Liang Jiang, Yuan Liao, Hao Qian, Li-Juan Wang, Xiao-Long Fu, Shen Zhao
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  ABSTRACT: A prospective Phase I/II dose escalation study was conducted to determine the maximum tolerated dose (MTD) in three-dimensional conformal radiation therapy (3D-CRT) for non-small-cell lung cancer (NSCLC). MTD would be reached via a dose escalation study. After 42 Gy/21 fractions, 4.2 weeks by conventional fractionated irradiation through anteroposterior/posteroanterior fields, the 3D-CRT technique was used as boost. The planned total dose escalation depended on lung volume irradiated. According to the percentage of lung volume receiving >20 Gy, the patients were divided into three subgroups (i.e., <25%, 25%-37%, and >37%). The scheduled dose escalation began with 69 Gy and continued to 78 Gy. The boost doses were delivered at 3 Gy per fraction, once per day, five fractions per week. Each dose level includes 5 patients. Besides radiotherapy, all patients received neoadjuvant and adjuvant chemotherapy with MVP regimen (Mitomycin, Vindesine, cis-platium). The criterion for stopping further dose escalation was > or =20% of patients with > or =RTOG Grade 3 radiation pneumonitis. Between June 1999 and February 2001, 50 patients had been enrolled in this study, including 4 with Stage II disease, 31 with Stage IIIa disease, and 15 with Stage IIIb disease. The dose escalation plan has been completed. All subgroups reached the highest predetermined dose levels (i.e., 78 Gy for the <25% subgroup, 78 Gy for the 25-37% subgroup, and 75 Gy for the >37% subgroup). Although none of the subgroups developed more than 20% of >/=Grade 3 acute pneumonitis, dose escalation was terminated because long-term follow-up was needed to observe late complications. Median follow-up time (MFT) for the entire group was 18 months (6-37 months). The most common acute complication was esophagitis in 56% of patients with RTOG Grade 1-2, and in 4% with Grade 3. Acute radiation pneumonitis developed in 36% of patients with RTOG Grade 1-2. Only 1 patient had Grade 3 pneumonitis, which was in the 25-37% subgroup at 75 Gy. The hematopoietic toxicity appeared in 58% of patients with Grade 1-2, and 8% with Grade 3. As to late complications, only 30% of patients developed pulmonary fibrosis of RTOG Grade 1-2. The median survival time for the entire group was 18 months. Two-year overall survival, locoregional progression-free rate, and distant metastasis rate were 44%, 40%, and 41%, respectively. Although MFT was 18 months, it had not yet been declared because a longer follow-up was needed to observe the late complications. The 2-year overall survival of 44% was very encouraging and implied that 3D-CRT combined with chemotherapy would improve the outcome for locally advanced NSCLC.
  International Journal of Radiation OncologyBiologyPhysics 01/2004; 57(5):1336-44. · 4.11 Impact Factor
• Article: [Phase I clinical trial of dose escalation on three dimensional conformal radiation therapy for non-small cell lung cancer].

  K Wu, G Jiang, Y Liao, L Wang, H Qian, H Yang, Z Zhang, C Hu, S Zhao
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  ABSTRACT: To establish the technique of 3-dimensional conformal radiation therapy (3DCRT) for non-small cell lung cancer (NSCLC) in stage II-IIIB,and to assess its acute side-effects and to obtain the maximum tolerance dose (MTD). From June,1999 to June,2000,38 cases of NSCLC in stage II-IIIB were enrolled in this study.MTD was identified by dose escalation study.After 42Gy/21Fx/4.2wks by conventional fractionated irradiation through AP/PA fields,which covered the primary tumor and lymph nodes,the technique of 3DCRT was used as boost.The boost fields encompassed the clinical lesions showed on chest CT.The planning of total dose escalation depended on the percentage,i.e.,<25%,25%-37%,and >37% of normal lung volume irradiated to over 20Gy.The scheduled dose escalation ranged from 69 to 81Gy.The criteria for stopping dose escalation was grade III or more worse radiation pneumonitis (RTOG).The boost doses were delivered with 3Gy/fraction,once a day,5 fractions a week. Thirty-three cases had completed their treatments and could be evaluated by now.Acute radiation pneumonitis occurred in 26% of patients with grade I-II and 3% with grade III,and acute radiation esophagitis in 61% with grade I-II and 9% with grade III,and the hematopoietic toxicity in 58% with grade I-II and 9% with grade III.The current doses implemented were 78,78,and 75Gy respectively for patients with <25%,25%-37%,and >37% of normal lung volume irradiated.The overall immediate response rate of tumors was 88%(29/33). Dose escalation in a volume-dependent organ as the lungs is acceptable and applicable.The immediate response is encouraging.MTD is to be determined.The long-term follow-up is needed to observe late complications and treatment efficacy.
  Zhongguo fei ai za zhi = Chinese journal of lung cancer 10/2000; 3(5):322-5.