Ursula Nestle1, Sonja Adebahr2, Klaus Kaier3, Eleni Gkika4, Tanja Schimek-Jasch4, Marlene Hechtner5, Felix Momm6, Jan Gaertner7, Gerhild Becker8, Anca-Ligia Grosu9. 1. Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany; Department of Radiation Oncology, Kliniken Maria Hilf GmbH Mönchengladbach, Germany. 2. Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address: sonja.adebahr@uniklinik-freiburg.de. 3. Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Germany. 4. Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany. 5. Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Germany; German Cancer Consortium (DKTK), Partner Site Mainz, Germany. 6. Department of Radio-oncology, Ortenau Klinikum Offenburg-Kehl, Germany. 7. Palliative Care Center Hildegard, Basel, Switzerland. 8. Clinic for Palliative Care, Medical Center, Faculty of Medicine, University of Freiburg, Germany. 9. Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
BACKGROUND AND PURPOSE: Preserving health related quality of life (HRQOL) plays an important role in considering stereotactic body fractionated radiotherapy (SBRT). The prospective monocenter phase II STRIPE trial investigated long-term HRQOL after SBRT, efficacy and toxicity. MATERIALS AND METHODS: Patients with ≤2 pulmonary lesions ≤5 cm were treated with 4DPET/CT-based SBRT (3 × 12.5 Gy or risk-adapted 5 × 7 Gy, to 60% isodose). Follow up (FU) was performed 2 and 7 weeks after SBRT, then 3-monthly for 2 years with assessment of response (primary endpoint: 2-year cumulative incidence of local progression (LP); secondary endpoints: local progression free survival (LPFS), overall survival (OS) and toxicity (CTCAE)). Impact of predefined patient and treatment related factors on HRQOL (EORTC QLQ-C30 and EORTC QLQ-LC13) was evaluated. RESULTS: Between 02/2011 and 11/2014, 100 patients were given SBRT for 56 NSCLC and 44 pulmonary metastases (M1). Long-term FU overall revealed stable Quality of Life (QoL)/Global health status (GHS), functions-scores and symptoms. For QoL/GHS, patients with low (<median) initial QoL/GHS-Score revealed significantly stronger improvement than those with good QoL/GHS-scores (p < 0.001). Probability for LP, LPFS and OS 2 years after SBRT was 8.1% (NSCLC: 7.3%, M1:9.2%), 53.3% (NSCLC: 50.7%, M1: 56.0%) and 62.2% (NSCLC: 57.2%, M1: 68.4%). ≥G3-Toxicity was <4%, but ≥G3 dyspnea was 6% at baseline and 14.5% 2 years after SBRT. CONCLUSIONS: These prospective data on representative pulmonary SBRT patients confirm stable preservation of HRQOL after SBRT and demonstrate a QoL/GHS-benefit for patients with low initial QoL/GHS-scores, the regimen of 3 × 12.5 Gy SBRT being efficient and well tolerated. This result may inform shared decision making when discussing SBRT for frail patients.
BACKGROUND AND PURPOSE: Preserving health related quality of life (HRQOL) plays an important role in considering stereotactic body fractionated radiotherapy (SBRT). The prospective monocenter phase II STRIPE trial investigated long-term HRQOL after SBRT, efficacy and toxicity. MATERIALS AND METHODS:Patients with ≤2 pulmonary lesions ≤5 cm were treated with 4DPET/CT-based SBRT (3 × 12.5 Gy or risk-adapted 5 × 7 Gy, to 60% isodose). Follow up (FU) was performed 2 and 7 weeks after SBRT, then 3-monthly for 2 years with assessment of response (primary endpoint: 2-year cumulative incidence of local progression (LP); secondary endpoints: local progression free survival (LPFS), overall survival (OS) and toxicity (CTCAE)). Impact of predefined patient and treatment related factors on HRQOL (EORTC QLQ-C30 and EORTC QLQ-LC13) was evaluated. RESULTS: Between 02/2011 and 11/2014, 100 patients were given SBRT for 56 NSCLC and 44 pulmonary metastases (M1). Long-term FU overall revealed stable Quality of Life (QoL)/Global health status (GHS), functions-scores and symptoms. For QoL/GHS, patients with low (<median) initial QoL/GHS-Score revealed significantly stronger improvement than those with good QoL/GHS-scores (p < 0.001). Probability for LP, LPFS and OS 2 years after SBRT was 8.1% (NSCLC: 7.3%, M1:9.2%), 53.3% (NSCLC: 50.7%, M1: 56.0%) and 62.2% (NSCLC: 57.2%, M1: 68.4%). ≥G3-Toxicity was <4%, but ≥G3 dyspnea was 6% at baseline and 14.5% 2 years after SBRT. CONCLUSIONS: These prospective data on representative pulmonary SBRT patients confirm stable preservation of HRQOL after SBRT and demonstrate a QoL/GHS-benefit for patients with low initial QoL/GHS-scores, the regimen of 3 × 12.5 Gy SBRT being efficient and well tolerated. This result may inform shared decision making when discussing SBRT for frail patients.
Authors: Henry S Park; Frank C Detterbeck; David C Madoff; Brett C Bade; Ulas Kumbasar; Vincent J Mase; Andrew X Li; Justin D Blasberg; Gavitt A Woodard; Whitney S Brandt; Roy H Decker Journal: J Thorac Dis Date: 2022-06 Impact factor: 3.005
Authors: Elisa Jiménez-Ortega; Raquel Agüera; Ana Ureba; Marcin Balcerzyk; Amadeo Wals-Zurita; Francisco Javier García-Gómez; Antonio Leal Journal: Tomography Date: 2022-04-12
Authors: Eleni Gkika; Sonja Adebahr; Anton Brenner; Tanja Schimek-Jasch; Gianluca Radicioni; Jan-Philipp Exner; Alexander Rühle; Simon K B Spohn; Ilinca Popp; Constantinos Zamboglou; Tanja Sprave; Elke Firat; Gabriele Niedermann; Nils Henrik Nicolay; Ursula Nestle; Anca-Ligia Grosu; Dan G Duda Journal: Cancers (Basel) Date: 2021-11-16 Impact factor: 6.639
Authors: Laura Cella; Serena Monti; Maria Thor; Andreas Rimner; Joseph O Deasy; Giuseppe Palma Journal: Cancers (Basel) Date: 2021-07-25 Impact factor: 6.639