PURPOSE: To report our institutional experience using image-guided stereotactic body radiation therapy (SBRT) for early stage lung cancer, including an analysis into factors associated with nodal and distant failures (NF, DF). METHODS: Forty-eight patients with early-stage primary lung cancer were treated with image-guided SBRT between 2007 and 2009. Median prescription dose was 48 Gy in 4 fractions. Toxicity was graded according to the NCI CTCAE v3.0 scale. RESULTS: Local failure was detected in two lesions and actuarial 24-month local control was 95%. At 24 months, the cumulative incidence of NF was 6%, and DF was 29%. Larger lesions (>3 cm) and younger age (<70 years) were the only factors found to be significantly correlated with increased DF (p=0.005 and p=0.015, respectively). A single grade ≥ 3 toxicity was observed. After adjusting for age and lesion size, distant failure was significantly associated with a poorer OS (Cox regression, p=0.0059). CONCLUSION: Image-guided SBRT can produce excellent LC rates with minimal toxicity. Distant failure was a major determinant of OS and the most common pattern of failure, indicating a potential role for systemic therapy in younger patients with large lesions.
PURPOSE: To report our institutional experience using image-guided stereotactic body radiation therapy (SBRT) for early stage lung cancer, including an analysis into factors associated with nodal and distant failures (NF, DF). METHODS: Forty-eight patients with early-stage primary lung cancer were treated with image-guided SBRT between 2007 and 2009. Median prescription dose was 48 Gy in 4 fractions. Toxicity was graded according to the NCI CTCAE v3.0 scale. RESULTS:Local failure was detected in two lesions and actuarial 24-month local control was 95%. At 24 months, the cumulative incidence of NF was 6%, and DF was 29%. Larger lesions (>3 cm) and younger age (<70 years) were the only factors found to be significantly correlated with increased DF (p=0.005 and p=0.015, respectively). A single grade ≥ 3 toxicity was observed. After adjusting for age and lesion size, distant failure was significantly associated with a poorer OS (Cox regression, p=0.0059). CONCLUSION: Image-guided SBRT can produce excellent LC rates with minimal toxicity. Distant failure was a major determinant of OS and the most common pattern of failure, indicating a potential role for systemic therapy in younger patients with large lesions.
Authors: Shulong Li; Ning Yang; Bin Li; Zhiguo Zhou; Hongxia Hao; Michael R Folkert; Puneeth Iyengar; Kenneth Westover; Hak Choy; Robert Timmerman; Steve Jiang; Jing Wang Journal: Med Image Anal Date: 2018-09-15 Impact factor: 8.545
Authors: Feng Liu; An Tai; Percy Lee; Tithi Biswas; George X Ding; Isaam El Naqa; Jimm Grimm; Andrew Jackson; Feng-Ming Spring Kong; Tamara LaCouture; Billy Loo; Moyed Miften; Timothy Solberg; X Allen Li Journal: Radiother Oncol Date: 2016-11-18 Impact factor: 6.280
Authors: Richard J Cassidy; Pretesh R Patel; Xinyan Zhang; Robert H Press; Jeffrey M Switchenko; Rathi N Pillai; Taofeek K Owonikoko; Suresh S Ramalingam; Felix G Fernandez; Seth D Force; Walter J Curran; Kristin A Higgins Journal: Clin Lung Cancer Date: 2017-03-16 Impact factor: 4.785
Authors: M Essler; J Wantke; B Mayer; K Scheidhauer; R A Bundschuh; B Haller; S T Astner; M Molls; N Andratschke Journal: Strahlenther Onkol Date: 2013-04-24 Impact factor: 3.621
Authors: Daniel Kim; Mark M Fuster; Sameer K Nath; Anjali Bharne; William Read; Lyudmilla Bazhenova; William Y Song; Arno J Mundt; Ajay P Sandhu Journal: J Radiosurg SBRT Date: 2012