Background.Many studies have demonstrated that a higher radiotherapy dose is associated with improved outcomes in non-smallcell\nlung cancer (NSCLC). We performed a dosimetric planning study to assess the dosimetric feasibility of intensity-modulated\nradiation therapy (IMRT) with a simultaneous integrated boost (SIB) in locally advanced NSCLC. Methods. We enrolled twenty\npatients. Five different dose plans were generated for each patient. All plans were prescribed a dose of 60Gy to the planning tumor\nvolume (PTV). In the three SIB groups, the prescribed dose was 69Gy, 75Gy, and 81Gy in 30 fractions to the internal gross tumor\nvolume (iGTV). Results. The SIB-IMRT plans were associated with a significant increase in the iGTV dose (P < 0.05), without\nincreased normal tissue exposure or prolonged overall treatment time. Significant differences were not observed in the dose to the\nnormal lung in terms of the V5 and V20 among the four IMRT plans.The maximum dose (Dmax) in the esophagus moderately\nincreased along with the prescribed dose (P < 0.05). Conclusions. Our results indicated that escalating the dose by SIB-IMRT is\ndosimetrically feasible; however, systematic evaluations via clinical trials are still warranted. We have designed a further clinical\nstudy (which is registered with ClinicalTrials.gov, number NCT02841228).
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