BACKGROUND AND PURPOSE: Stereotactic ablative radiotherapy (SABR) has improved the survival for medically inoperable patients with peripheral early-stage non-small cell lung cancer (NSCLC). We performed a systematic review of outcomes for central lung tumours. MATERIAL AND METHODS: The systematic review was performed following PRISMA guidelines. Survival outcomes were evaluated for central early-stage NSCLC. Local control and toxicity outcomes were evaluated for any centrally-located lung tumour. RESULTS: Twenty publications met the inclusion criteria, reporting outcomes for 563 central lung tumours, including 315 patients with early-stage NSCLC. There was heterogeneity in the planning, prescribing and delivery of SABR and the common toxicity criteria used to define toxicities (versions 2.0-4.0). Tumour location (central versus peripheral) did not impact overall survival. Local control rates were ≥ 85% when the prescribed biologically equivalent tumour dose was ≥ 100 Gy. Treatment-related mortality was 2.7% overall, and 1.0% when the biologically equivalent normal tissue dose was ≤ 210 Gy. Grade 3 or 4 toxicities may be more common following SABR for central tumours, but occurred in less than 9% of patients. CONCLUSIONS: Post-SABR survival for early-stage NSCLC is not affected by tumour location. SABR achieves high local control with limited toxicity when appropriate fractionation schedules are used for central tumours.
BACKGROUND AND PURPOSE: Stereotactic ablative radiotherapy (SABR) has improved the survival for medically inoperable patients with peripheral early-stage non-small cell lung cancer (NSCLC). We performed a systematic review of outcomes for central lung tumours. MATERIAL AND METHODS: The systematic review was performed following PRISMA guidelines. Survival outcomes were evaluated for central early-stage NSCLC. Local control and toxicity outcomes were evaluated for any centrally-located lung tumour. RESULTS: Twenty publications met the inclusion criteria, reporting outcomes for 563 central lung tumours, including 315 patients with early-stage NSCLC. There was heterogeneity in the planning, prescribing and delivery of SABR and the common toxicity criteria used to define toxicities (versions 2.0-4.0). Tumour location (central versus peripheral) did not impact overall survival. Local control rates were ≥ 85% when the prescribed biologically equivalent tumour dose was ≥ 100 Gy. Treatment-related mortality was 2.7% overall, and 1.0% when the biologically equivalent normal tissue dose was ≤ 210 Gy. Grade 3 or 4 toxicities may be more common following SABR for central tumours, but occurred in less than 9% of patients. CONCLUSIONS: Post-SABR survival for early-stage NSCLC is not affected by tumour location. SABR achieves high local control with limited toxicity when appropriate fractionation schedules are used for central tumours.
Authors: S Adebahr; S Collette; E Shash; M Lambrecht; C Le Pechoux; C Faivre-Finn; D De Ruysscher; H Peulen; J Belderbos; R Dziadziuszko; C Fink; M Guckenberger; C Hurkmans; U Nestle Journal: Br J Radiol Date: 2015-04-15 Impact factor: 3.039
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: Abraham J Wu; Eric Williams; Ankit Modh; Amanda Foster; Ellen Yorke; Andreas Rimner; Andrew Jackson Journal: Radiother Oncol Date: 2014-07-23 Impact factor: 6.280
Authors: Justin M Haseltine; Andreas Rimner; Daphna Y Gelblum; Ankit Modh; Kenneth E Rosenzweig; Andrew Jackson; Ellen D Yorke; Abraham J Wu Journal: Pract Radiat Oncol Date: 2015-11-11