International journal of radiation oncology, biology, physics, 2012-02, Vol.82 (2), p.967-973
2012
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- Autor(en) / Beteiligte
- Titel
- Stereotactic Body Radiotherapy for Medically Inoperable Lung Cancer: Prospective, Single-Center Study of 108 Consecutive Patients
- Ist Teil von
- International journal of radiation oncology, biology, physics, 2012-02, Vol.82 (2), p.967-973
- Ort / Verlag
- New York, NY: Elsevier Inc
- Erscheinungsjahr
- 2012
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- Purpose To present the results of stereotactic body radiotherapy (SBRT) for medically inoperable patients with Stage I non–small-cell lung cancer (NSCLC) and contrast outcomes in patients with and without a pathologic diagnosis. Methods and Materials Between December 2004 and October 2008, 108 patients (114 tumors) underwent treatment according to the prospective research ethics board-approved SBRT protocols at our cancer center. Of the 108 patients, 88 (81.5%) had undergone pretreatment whole-body [18F]-fluorodeoxyglucose positron emission tomography/computed tomography. A pathologic diagnosis was unavailable for 33 (28.9%) of the 114 lesions. The SBRT schedules included 48 Gy in 4 fractions or 54–60 Gy in 3 fractions for peripheral lesions and 50–60 Gy in 8–10 fractions for central lesions. Toxicity and radiologic response were assessed at the 3–6-month follow-up visits using conventional criteria. Results The mean tumor diameter was 2.4-cm (range, 0.9–5.7). The median follow-up was 19.1 months (range, 1–55.7). The estimated local control rate at 1 and 4 years was 92% (95% confidence interval [CI], 86–97%) and 89% (95% CI, 81–96%). The cause-specific survival rate at 1 and 4 years was 92% (95% CI, 87–98%) and 77% (95% CI, 64–89%), respectively. No statistically significant difference was found in the local, regional, and distant control between patients with and without pathologically confirmed NSCLC. The most common acute toxicity was Grade 1 or 2 fatigue (53 of 108 patients). No toxicities of Grade 4 or greater were identified. Conclusions Lung SBRT for early-stage NSCLC resulted in excellent local control and cause-specific survival with minimal toxicity. The disease-specific outcomes were comparable for patients with and without a pathologic diagnosis. SBRT can be considered an option for selected patients with proven or presumed early-stage NSCLC.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0360-3016eISSN: 1879-355XDOI: 10.1016/j.ijrobp.2010.12.039Titel-ID: cdi_osti_scitechconnect_22056065
- Format
- –
- Schlagworte
- Aged, Aged, 80 and over, Biological and medical sciences, Cancer Care Facilities, Carcinoma, Non-Small-Cell Lung - diagnostic imaging, Carcinoma, Non-Small-Cell Lung - mortality, Carcinoma, Non-Small-Cell Lung - pathology, Carcinoma, Non-Small-Cell Lung - surgery, Confidence Intervals, DIAGNOSIS, Disease-Free Survival, Dose Fractionation, ETHICAL ASPECTS, FATIGUE, Female, FLUORINE 18, FLUORODEOXYGLUCOSE, Fluorodeoxyglucose F18, Hematology, Oncology and Palliative Medicine, Humans, Image-guided radiotherapy, Lung Neoplasms - diagnostic imaging, Lung Neoplasms - mortality, Lung Neoplasms - pathology, Lung Neoplasms - surgery, LUNGS, Male, Medical sciences, Middle Aged, Multimodal Imaging, NEOPLASMS, Non–small-cell lung cancer, Ontario, PATIENTS, Pneumology, POSITRON COMPUTED TOMOGRAPHY, Positron-Emission Tomography, Prospective Studies, Pulmonary nodules, Radiation Injuries - pathology, Radiology, RADIOLOGY AND NUCLEAR MEDICINE, Radiopharmaceuticals, Radiosurgery - adverse effects, Radiosurgery - methods, RADIOTHERAPY, Radiotherapy toxicity, Radiotherapy, Image-Guided - methods, Stereotactic body radiotherapy, Survival Rate, Tomography, X-Ray Computed, TOXICITY, Treatment Outcome, Tumor Burden, Tumors of the respiratory system and mediastinum