P Mª Samper Ots1, C Vallejo Ocaña2, M Martin Martin2, F J Celada Álvarez3, D Farga Albiol3, P Almendros Blanco4, A Hernandez Machancoses4, M Rico Oses5, S Flamarique Andueza5, F Romero Ruperto6, C Maria Bueno6, E Amaya Escobar7, L L Guerrero Gómez8, F Couñago9, Mª Del Pino Alcántara10, Mª J Ruiz Villar11, J L Monroy Antón12, P Saez Bueno13, J Luna Tirado14, Mª Del Mar Puertas15, A Bobo16, I Diaz de Cerio Martínez17, N Gascon Costoso18, C Ferrer Albiach19. 1. Hospital Universitario Rey Juan Carlos, Móstoles, Spain. pisamot@gmail.com. 2. Hospital Universitario Ramón y Cajal, Madrid, Spain. 3. Hospital Universitario y Politécnico La Fe, Valencia, Spain. 4. Hospital General de Valencia, Valencia, Spain. 5. Complejo Hospitalario de Navarra, Navarra, Spain. 6. Hospital Universitario Reina Sofía, Córdoba, Spain. 7. Hospital Universitario Rey Juan Carlos, Móstoles, Spain. 8. Hospital La Luz Madrid Quironsalud Madrid, Madrid, Spain. 9. Hospital Universitario Quironsalud y Hospital La Luz Quironsalud, Madrid, Spain. 10. Hospital Universitario Clínico San Carlos, Madrid, Spain. 11. Hospital Universitario La Paz, Madrid, Spain. 12. Hospital Universitario de la Rivera, Alcira, Valencia, Spain. 13. Hospital Universitario Central de la Defensa "Gómez Ulla", Madrid, Spain. 14. Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. 15. Hospital Universitario Miguel Servet, Zaragoza, Spain. 16. Hospital Ruber Internacional, Madrid, Spain. 17. Hospital Universitario Marques de Valdecilla, Santander, Spain. 18. Hospital Universitario 12 de Octubre, Madrid, Spain. 19. Complejo Hospitalario Castellón, Castellón, Spain.
Abstract
PURPOSE/OBJECTIVE(S): Stereotactic body radiotherapy (SBRT) has become the standard of care for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and for patients who refuse surgery. The aim of this study was to evaluate the effectiveness and safety of primary SBRT in patients with early-stage NSCLC. MATERIALS/ METHODS: Retrospective multicenter study of 397 patients (416 primary lung tumours) treated with SBRT at 18 centres in Spain. 83.2% were men. The median age was 74.4 years. In 94.4% of cases, the tumour was inoperable. The pathological report was available in 54.6% of cases. SPSS vs 22.0. was used to perform all statistical analyses. RESULTS: Complete response was obtained in 53.6% of cases. Significant prognostic factors were standard CT planning (p = 0.014) and 4D cone beam CT (p = 0.000). Acute and chronic toxicity ≥ grade 3 was observed in 1.2% of cases. At a median follow-up of 30 months, local relapse was 9.6%, lymph node relapse 12.8%, distant metastasis 16.6%, and another lung tumour 11.5%. Complete response was the only significant prognostic factor for local relapse (p = 0.012) and distant metastasis (p = 0.001). The local relapse-free survival was 88.7%. The overall survival was 75.7%. The cancer-specific survival was 92.7%. The disease-free survival was 78.7%. CONCLUSION: SBRT is an effective and well-tolerated treatment option for patients with early-stage lung cancer who are not suitable for surgery. The most important prognostic factor for local and distant recurrence was complete response, which in our sample depended on the type of CT planning and the IGRT technique.
PURPOSE/OBJECTIVE(S): Stereotactic body radiotherapy (SBRT) has become the standard of care for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and for patients who refuse surgery. The aim of this study was to evaluate the effectiveness and safety of primary SBRT in patients with early-stage NSCLC. MATERIALS/ METHODS: Retrospective multicenter study of 397 patients (416 primary lung tumours) treated with SBRT at 18 centres in Spain. 83.2% were men. The median age was 74.4 years. In 94.4% of cases, the tumour was inoperable. The pathological report was available in 54.6% of cases. SPSS vs 22.0. was used to perform all statistical analyses. RESULTS: Complete response was obtained in 53.6% of cases. Significant prognostic factors were standard CT planning (p = 0.014) and 4D cone beam CT (p = 0.000). Acute and chronic toxicity ≥ grade 3 was observed in 1.2% of cases. At a median follow-up of 30 months, local relapse was 9.6%, lymph node relapse 12.8%, distant metastasis 16.6%, and another lung tumour 11.5%. Complete response was the only significant prognostic factor for local relapse (p = 0.012) and distant metastasis (p = 0.001). The local relapse-free survival was 88.7%. The overall survival was 75.7%. The cancer-specific survival was 92.7%. The disease-free survival was 78.7%. CONCLUSION: SBRT is an effective and well-tolerated treatment option for patients with early-stage lung cancer who are not suitable for surgery. The most important prognostic factor for local and distant recurrence was complete response, which in our sample depended on the type of CT planning and the IGRT technique.
Authors: Alexander V Louie; Erik van Werkhoven; Hanbo Chen; Egbert F Smit; Marinus A Paul; Joachim Widder; Harry J M Groen; Ben E E M van den Borne; Katrien De Jaeger; Ben J Slotman; Suresh Senan Journal: Radiother Oncol Date: 2015-10 Impact factor: 6.280