PURPOSE: A Phase I dose escalation study of stereotactic body radiation therapy to assess toxicity and local control rates for patients with medically inoperable Stage I lung cancer. METHODS AND MATERIALS: All patients had non-small-cell lung carcinoma, Stage T1a or T1b N0, M0. Patients were immobilized in a stereotactic body frame and treated in escalating doses of radiotherapy beginning at 24 Gy total (3 x 8 Gy fractions) using 7-10 beams. Cohorts were dose escalated by 6.0 Gy total with appropriate observation periods. RESULTS: The maximum tolerated dose was not achieved in the T1 stratum (maximum dose = 60 Gy), but within the T2 stratum, the maximum tolerated dose was realized at 72 Gy for tumors larger than 5 cm. Dose-limiting toxicity included predominantly bronchitis, pericardial effusion, hypoxia, and pneumonitis. Local failure occurred in 4/19 T1 and 6/28 T2 patients. Nine local failures occurred at doses < or =16 Gy and only 1 at higher doses. Local failures occurred between 3 and 31 months from treatment. Within the T1 group, 5 patients had distant or regional recurrence as an isolated event, whereas 3 patients had both distant and regional recurrence. Within the T2 group, 2 patients had solitary regional recurrences, and the 4 patients who failed distantly also failed regionally. CONCLUSIONS: Stereotactic body radiation therapy seems to be a safe, effective means of treating early-stage lung cancer in medically inoperable patients. Excellent local control was achieved at higher dose cohorts with apparent dose-limiting toxicities in patients with larger tumors.
PURPOSE: A Phase I dose escalation study of stereotactic body radiation therapy to assess toxicity and local control rates for patients with medically inoperable Stage I lung cancer. METHODS AND MATERIALS: All patients had non-small-cell lung carcinoma, Stage T1a or T1b N0, M0. Patients were immobilized in a stereotactic body frame and treated in escalating doses of radiotherapy beginning at 24 Gy total (3 x 8 Gy fractions) using 7-10 beams. Cohorts were dose escalated by 6.0 Gy total with appropriate observation periods. RESULTS: The maximum tolerated dose was not achieved in the T1 stratum (maximum dose = 60 Gy), but within the T2 stratum, the maximum tolerated dose was realized at 72 Gy for tumors larger than 5 cm. Dose-limiting toxicity included predominantly bronchitis, pericardial effusion, hypoxia, and pneumonitis. Local failure occurred in 4/19 T1 and 6/28 T2 patients. Nine local failures occurred at doses < or =16 Gy and only 1 at higher doses. Local failures occurred between 3 and 31 months from treatment. Within the T1 group, 5 patients had distant or regional recurrence as an isolated event, whereas 3 patients had both distant and regional recurrence. Within the T2 group, 2 patients had solitary regional recurrences, and the 4 patients who failed distantly also failed regionally. CONCLUSIONS: Stereotactic body radiation therapy seems to be a safe, effective means of treating early-stage lung cancer in medically inoperable patients. Excellent local control was achieved at higher dose cohorts with apparent dose-limiting toxicities in patients with larger tumors.
Authors: S Arcangeli; L Agolli; L Portalone; M R Migliorino; M G Lopergolo; A Monaco; J Dognini; M C Pressello; S Bracci; V Donato Journal: Br J Radiol Date: 2015-02-03 Impact factor: 3.039
Authors: Joe Y Chang; Peter A Balter; Lei Dong; Qiuan Yang; Zhongxing Liao; Melenda Jeter; M Kara Bucci; Mary F McAleer; Reza J Mehran; Jack A Roth; Ritsuko Komaki Journal: Int J Radiat Oncol Biol Phys Date: 2008-11-15 Impact factor: 7.038
Authors: Amit Sawant; Raghu Venkat; Vikram Srivastava; David Carlson; Sergey Povzner; Herb Cattell; Paul Keall Journal: Med Phys Date: 2008-05 Impact factor: 4.071
Authors: Saloomeh Vahdat; Eric K Oermann; Sean P Collins; Xia Yu; Malak Abedalthagafi; Pedro Debrito; Simeng Suy; Shadi Yousefi; Constanza J Gutierrez; Thomas Chang; Filip Banovac; Eric D Anderson; Giuseppe Esposito; Brian T Collins Journal: J Hematol Oncol Date: 2010-02-04 Impact factor: 17.388