Five-year Long-term Outcomes of Stereotactic Body Radiation Therapy for Operable Versus Medically Inoperable Stage I Non-small-cell Lung Cancer: Analysis by Operability, Fractionation Regimen, Tumor Size, and Tumor Location
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Date
2019Journal
Clinical Lung CancerPublisher
Elsevier Inc.Type
Article
Metadata
Show full item recordAbstract
Background: Stereotactic body radiation therapy (SBRT) is standard for medically inoperable stage I non-small-cell lung cancer (NSCLC) and is emerging as a surgical alternative in operable patients. However, limited long-term outcomes data exist, particularly according to operability. We hypothesized long-term local control (LC) and cancer-specific survival (CSS) would not differ by fractionation schedule, tumor size or location, or operability status, but overall survival (OS) would be higher for operable patients. Patients and Methods: All consecutive patients with stage I (cT1-2aN0M0) NSCLC treated with SBRT from June 2009 to July 2013 were assessed. Thoracic surgeon evaluation determined operability. Local failure was defined as growth following initial tumor shrinkage or progression on consecutive scans. LC, CSS, and OS were calculated using Cox proportional hazards regression. Results: A total of 186 patients (204 lesions) were analyzed. Most patients were inoperable (82%) with Eastern Cooperative Oncology Group performance status of 1 (59%) or 2 (26%). All lesions received biological effective doses ? 100 Gy most commonly (94%) in 3 to 5 fractions. The median follow-up was 4.0 years. LC at 2 and 5 years were 95.6% (95% confidence interval, 92%-99%) and 93.7% (95% confidence interval, 90%-98%), respectively. Compared with operable patients, inoperable patients did not have significant differences in 5-year LC (93.1% vs. 96.7%; P =.49), nodal failure (31.4% vs. 11.0%; P =.12), distant failure (12.2% vs. 10.4%; P =.98), or CSS (80.6% vs. 91.0%; P =.45) but trended towards worse OS (34.2% vs. 45.3%; P =.068). Tumor size, location, and fractionation did not significantly influence outcomes. Conclusions: SBRT has excellent, durable LC and CSS rates for early-stage NSCLC, although inoperable patients had somewhat lower OS than operable patients, likely owing to greater comorbidities. Copyright 2018 Elsevier Inc.Stereotactic body radiation therapy is standard for inoperable stage I non-small-cell lung cancer and an emerging surgical alternative in operable patients. Limited long-term data exist according to operability. Analysis of 186 patients (204 lesions) demonstrates stereotactic body radiation therapy is well-tolerated with excellent local control (LC) (5-year LC, 93.7%). Inoperable patients achieved similar LC and cancer-specific survival but worse overall survival, likely owing to comorbidities.Identifier to cite or link to this item
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054741092&doi=10.1016%2fj.cllc.2018.09.004&partnerID=40&md5=cf4c3d12844e67c9b61a6b70683e35ea; http://hdl.handle.net/10713/10636ae974a485f413a2113503eed53cd6c53
10.1016/j.cllc.2018.09.004
Scopus Count
Collections
Related articles
- Multi-institutional analysis of stereotactic body radiation therapy for operable early-stage non-small cell lung carcinoma.
- Authors: Kann BH, Verma V, Stahl JM, Ross R, Dosoretz AP, Shafman TD, Gross CP, Park HS, Yu JB, Decker RH
- Issue date: 2019 May
- Feasible Optimization of Stereotactic Ablative Radiotherapy Dose by Tumor Size for Stage I Non-small-cell Lung Cancer.
- Authors: Lee S, Song SY, Kim SS, Choi W, Je HU, Back GM, Cho B, Jeong SY, Choi EK
- Issue date: 2018 Mar
- Stereotactic body radiation therapy (SBRT) improves local control and overall survival compared to conventionally fractionated radiation for stage I non-small cell lung cancer (NSCLC).
- Authors: von Reibnitz D, Shaikh F, Wu AJ, Treharne GC, Dick-Godfrey R, Foster A, Woo KM, Shi W, Zhang Z, Din SU, Gelblum DY, Yorke ED, Rosenzweig KE, Rimner A
- Issue date: 2018 Nov
- Lung stereotactic body radiation therapy for elderly patients aged ≥ 80 years with pathologically proven early-stage non-small cell lung cancer: a retrospective cohort study.
- Authors: Watanabe K, Katsui K, Sugiyama S, Yoshio K, Kuroda M, Hiraki T, Kiura K, Maeda Y, Toyooka S, Kanazawa S
- Issue date: 2021 Feb 23
- Stereotactic Ablative Radiotherapy as an Alternative to Lobectomy in Patients With Medically Operable Stage I NSCLC: A Retrospective, Multicenter Analysis.
- Authors: Scotti V, Bruni A, Francolini G, Perna M, Vasilyeva P, Loi M, Simontacchi G, Viggiano D, Lanfranchi B, Gonfiotti A, Topulli J, Olmetto E, Maragna V, Ferrari K, Bonti V, Comin C, Balduzzi S, D'Amico R, Lohr F, Voltolini L, Livi L
- Issue date: 2019 Jan