BACKGROUND AND PURPOSE: To report patterns of failure of stereotactic body radiation therapy (SBRT) in inoperable patients with histologically confirmed stage I NSCLC. MATERIALS AND METHODS: Ninety-two inoperable patients (median age: 75 years) with clinically staged, histologically proven T1 (n=31) or T2 (n=61), N0, M0 non-small cell lung cancer (NSCLC) were included in this study. Treatment consisted of 3-5 fractions with 7-15 Gy per fraction prescribed to the 60% isodose. RESULTS: Freedom from local recurrence at 1, 3 and 5 years was 89%, 83% and 83%, respectively. All 10 local failures were observed in patients with T2 tumors. Isolated regional recurrence was observed in 7.6%. The crude rate of distant progression was 20.7%. Overall survival at 1, 3, and 5 years was 79%, 38% and 17% with a median survival of 29 months. Disease specific survival at 1, 3, and 5 years was 93%, 64% and 48%. Karnofsky performance status, T stage, gross tumor volume and tumor location had no significant impact on overall and disease specific survival. SBRT was generally well tolerated and all patients completed therapy as planned. CONCLUSION: SBRT for stage I lung cancer is very well tolerated in this patient cohort with significant cardiopulmonal comorbidity and results in excellent local control rates, although a considerable portion develops regional and distant metastases.
BACKGROUND AND PURPOSE: To report patterns of failure of stereotactic body radiation therapy (SBRT) in inoperable patients with histologically confirmed stage I NSCLC. MATERIALS AND METHODS: Ninety-two inoperable patients (median age: 75 years) with clinically staged, histologically proven T1 (n=31) or T2 (n=61), N0, M0 non-small cell lung cancer (NSCLC) were included in this study. Treatment consisted of 3-5 fractions with 7-15 Gy per fraction prescribed to the 60% isodose. RESULTS: Freedom from local recurrence at 1, 3 and 5 years was 89%, 83% and 83%, respectively. All 10 local failures were observed in patients with T2 tumors. Isolated regional recurrence was observed in 7.6%. The crude rate of distant progression was 20.7%. Overall survival at 1, 3, and 5 years was 79%, 38% and 17% with a median survival of 29 months. Disease specific survival at 1, 3, and 5 years was 93%, 64% and 48%. Karnofsky performance status, T stage, gross tumor volume and tumor location had no significant impact on overall and disease specific survival. SBRT was generally well tolerated and all patients completed therapy as planned. CONCLUSION: SBRT for stage I lung cancer is very well tolerated in this patient cohort with significant cardiopulmonal comorbidity and results in excellent local control rates, although a considerable portion develops regional and distant metastases.
Authors: Daniel H Schanne; Ursula Nestle; Michael Allgäuer; Nicolaus Andratschke; Steffen Appold; Ute Dieckmann; Iris Ernst; Ute Ganswindt; Anca L Grosu; Richard Holy; Michael Molls; Meinhard Nevinny-Stickel; Sabine Semrau; Florian Sterzing; Andrea Wittig; Matthias Guckenberger Journal: Strahlenther Onkol Date: 2014-08-27 Impact factor: 3.621
Authors: Traves D Crabtree; Varun Puri; Clifford Robinson; Jeffrey Bradley; Stephen Broderick; G Alexander Patterson; Jingxia Liu; Joanne F Musick; Jennifer M Bell; Michael Yang; Bryan F Meyers Journal: J Thorac Cardiovasc Surg Date: 2014-01-02 Impact factor: 5.209
Authors: William R Kennedy; Prashant Gabani; John Nikitas; Clifford G Robinson; Jeffrey D Bradley; Michael C Roach Journal: Radiother Oncol Date: 2019-08-31 Impact factor: 6.280
Authors: Stacey Su; Walter J Scott; Mark S Allen; Gail E Darling; Paul A Decker; Robert J McKenna; Bryan F Meyers Journal: J Thorac Cardiovasc Surg Date: 2013-11-26 Impact factor: 5.209