Justin Peterson1, Christian Niles1, Ashish Patel2, Ziad Boujaoude3, Wissam Abouzgheib3, Ben Goldsmith2, Sucha Asbell2, Qianyi Xu2, Polina Khrizman4, Gregory J Kubicek5. 1. Rowan Medical School, Camden, NJ. 2. Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ. 3. Department of Pulmonary Medicine, Cooper University Hospital, Camden, NJ. 4. Department of Medical Oncology, MD Anderson at Cooper University Hospital, Camden, NJ. 5. Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ. Electronic address: Kubicek-Gregory@cooperhealth.edu.
Abstract
BACKGROUND: Stereotactic body radiotherapy (SBRT) is a well-established treatment option for early stage non-small-cell lung cancer (NSCLC) tumors < 5 cm. There is limited information on tumors > 5 cm. PATIENTS AND METHODS: We performed retrospective data collection of patients enrolled onto a prospective SBRT registry study. Eligible patients for this study had node-negative NSCLC measuring > 5 cm in any dimension. Data from 41 patients were analyzed. Median patient age was 75 years, and median tumor size was 5.6 cm (range, 5.0-12.2 cm). Sixteen patients had squamous disease, 20 patients adenocarcinoma, and 1 mixed tumor; 4 patients had no biopsy. Median radiation dose per fraction was 50 Gy in 5 fractions. Radiation was prescribed to isodose line, median 66% (range, 50%-84%). RESULTS: Before SBRT, 6 patients had previous chemotherapy and 7 patients had previous radiation. Median follow-up for all patients was 15.2 months (range, 0.56-48.1 months). At last follow-up, 16 patients were still alive, with a median follow-up of 16.1 months for surviving patients. The median survival was 17.5 months with 1- and 2-year survivals of 65% and 34%. Two patients (4.8%) had local failure, and 13 patients (31%) had distant failure. Four patients (9.8%) had acute toxicity, and 7 patients (17.1%) had late toxicity, including 2 (4.8%) grade 3 late toxicities. CONCLUSION: SBRT for tumors > 5 cm is effective, with good local control rates and acceptable toxicity. The main pattern of failure is distant, suggesting a possible role for systemic chemotherapy in these patients.
BACKGROUND: Stereotactic body radiotherapy (SBRT) is a well-established treatment option for early stage non-small-cell lung cancer (NSCLC) tumors < 5 cm. There is limited information on tumors > 5 cm. PATIENTS AND METHODS: We performed retrospective data collection of patients enrolled onto a prospective SBRT registry study. Eligible patients for this study had node-negative NSCLC measuring > 5 cm in any dimension. Data from 41 patients were analyzed. Median patient age was 75 years, and median tumor size was 5.6 cm (range, 5.0-12.2 cm). Sixteen patients had squamous disease, 20 patientsadenocarcinoma, and 1 mixed tumor; 4 patients had no biopsy. Median radiation dose per fraction was 50 Gy in 5 fractions. Radiation was prescribed to isodose line, median 66% (range, 50%-84%). RESULTS: Before SBRT, 6 patients had previous chemotherapy and 7 patients had previous radiation. Median follow-up for all patients was 15.2 months (range, 0.56-48.1 months). At last follow-up, 16 patients were still alive, with a median follow-up of 16.1 months for surviving patients. The median survival was 17.5 months with 1- and 2-year survivals of 65% and 34%. Two patients (4.8%) had local failure, and 13 patients (31%) had distant failure. Four patients (9.8%) had acute toxicity, and 7 patients (17.1%) had late toxicity, including 2 (4.8%) grade 3 late toxicities. CONCLUSION: SBRT for tumors > 5 cm is effective, with good local control rates and acceptable toxicity. The main pattern of failure is distant, suggesting a possible role for systemic chemotherapy in these patients.
Authors: Joe Y Chang; Reza J Mehran; Lei Feng; Vivek Verma; Zhongxing Liao; James W Welsh; Steven H Lin; Michael S O'Reilly; Melenda D Jeter; Peter A Balter; Stephen E McRae; Donald Berry; John V Heymach; Jack A Roth Journal: Lancet Oncol Date: 2021-09-13 Impact factor: 54.433
Authors: Amber M Bates; Ryan J Brown; Alexander A Pieper; Luke M Zangl; Ian Arthur; Peter M Carlson; Trang Le; Gustavo A Sosa; Paul A Clark; Raghava N Sriramaneni; KyungMann Kim; Ravi B Patel; Zachary S Morris Journal: Front Oncol Date: 2021-04-15 Impact factor: 6.244